Abdel Karim Nagla, Khaddasn Sinan, Shehata Mahmoud, Mostafa Ahmed, Magdy Mohamed, Eldessouki Ihab, Xie Changchun, Benzequene Sadia
Hematology-Oncology Department Augusta University, U S A.
Hematology-Oncology Department, Vontz Center, University of Cincinnati, Ohio, U S A.
Asian Pac J Cancer Prev. 2020 Jan 1;21(1):175-178. doi: 10.31557/APJCP.2020.21.1.175.
Approximately 30% of lung cancer patients develop central airway obstruction (CAO) that remarkably shortens survival. There is little data about the benefits of stenting within this heterogeneous patient group. Our objective was to review their overall survival (OS) and their risk of hospitalization versus patients who did not have lesions requiring stent placement.
We retrospectively reviewed charts of 171 non-small cell lung cancer (NSCLC) patients who underwent bronchoscopy in the University of Cincinnati Cancer Center from the year 2011 to 2013. Twenty-five patients with advanced lung cancer were evaluated by interventional pulmonology service for endobronchial stent placement for CAO. Eight patients did not require placement of a stent and 17 had obstructive lesions that required stenting by interventional pulmonology.
Demographical parameters such as age and gender did not have a significant impact on the risk of hospitalization or OS of both groups of patients, however, those whose lesions did not mandate stent placement had significantly lower odds of hospitalization compared to patients with CAO requiring a stent (OR: 15.913, 95% CI: 1.211-209.068, P = 0.0352). Patients with advanced NSCLC and CAO that required stent placement had an OS of 13.9 m [3.9-19.9 m] compared to an OS of 23.9 m for patients with CAO not requiring a stent. We found out that patients with less severe CAO have lower odds of hospitalization and better OS compared to patients with CAO mandating stent placement.
CAO patients with interventional pulmonology (IP) evaluation and management in addition, may have improved OS suggesting that IP consultation might offer both improvement in quality of life and overall survival to patients with advanced NSCLC and CAO.
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约30%的肺癌患者会发生中央气道阻塞（CAO），这会显著缩短生存期。关于在这个异质性患者群体中进行支架置入术的益处，相关数据很少。我们的目的是比较他们的总生存期（OS）以及与那些没有需要支架置入病变的患者相比，他们的住院风险。
我们回顾性分析了2011年至2013年在辛辛那提大学癌症中心接受支气管镜检查的171例非小细胞肺癌（NSCLC）患者的病历。25例晚期肺癌患者由介入肺科进行评估，以确定是否需要为CAO置入支气管内支架。8例患者不需要置入支架，17例有阻塞性病变，需要介入肺科进行支架置入。
年龄和性别等人口统计学参数对两组患者的住院风险或总生存期没有显著影响，然而，与需要支架置入的CAO患者相比，那些病变不需要支架置入的患者住院几率显著更低（比值比：15.913，95%置信区间：1.211 - 209.068，P = 0.0352）。需要支架置入的晚期NSCLC和CAO患者的总生存期为13.9个月[3.9 - 19.9个月]，而不需要支架置入的CAO患者的总生存期为23.9个月。我们发现，与需要支架置入的CAO患者相比，CAO较轻的患者住院几率更低，总生存期更好。
此外，接受介入肺科（IP）评估和管理的CAO患者可能总生存期有所改善，这表明IP会诊可能会提高晚期NSCLC和CAO患者的生活质量和总生存期。
