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手术治疗的病理ⅢA期非小细胞肺癌预后因素的确定

Determination of prognostic factors of surgically treated pathological Stage IIIA non-small cell lung cancer.

作者信息

Sayan Muhammet, Valiyev Elgun, Satır Türk Merve, Baş Aynur, Çelik Ali, Kurul İsmail Cüneyt, Arıbaş Olgun Kadir, Taştepe Abdullah İrfan

机构信息

Department of Thoracic Surgery, Medicine Faculty of Gazi University, Ankara, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jul 28;28(3):496-504. doi: 10.5606/tgkdc.dergisi.2020.18824. eCollection 2020 Jul.

Abstract

BACKGROUND

This study aims to identify the prognostic factors in Stage IIIA non-small cell lung cancer and to investigate whether there was a significant difference in terms of overall survival and diseasefree survival among the subgroups belonging to this disease stage.

METHODS

Between January 2010 and December 2018, a total of 144 patients (125 males, 19 females; median age 60 years; range, 41 to 80 years) who were operated for non-small cell lung cancer in our clinic and whose pathological stage was reported as IIIA were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, histopathological diagnosis, the standardized uptake value of the mass on positron emission tomography-computed tomography, tumor diameter, type of surgery, lymph node metastasis status, visceral pleural invasion, and overall and disease-free survival rates were recorded.

RESULTS

The median survival was 39 (range, 27.8 to 46.1) months and the five-year overall survival rate was 28%. The mean tumor diameter was 4.3±2.7 cm. The median disease-free survival was 37 (range, 28.1 to 48.6) months and the five-year disease-free survival rate was 26.9%. In the multivariate analysis, overall survival and disease-free survival in T2N2M0 subgroup were significantly worse than the other subgroups. The other poor prognostic factors of survival were the standardized uptake value of the tumor, pneumonectomy, and histopathological subtypes other than squamous cell carcinoma and adenocarcinoma. Parietal pleural invasion was significantly associated with worse disease-free survival rates.

CONCLUSION

Our results showed that there may be significant survival differences between subgroups created by tumor histopathology, lymph node invasion and the type of surgery in a heterogeneous lung cancer stage.

摘要

背景

本研究旨在确定ⅢA期非小细胞肺癌的预后因素,并调查该疾病阶段各亚组在总生存期和无病生存期方面是否存在显著差异。

方法

回顾性分析2010年1月至2018年12月期间在我院接受非小细胞肺癌手术且病理分期报告为ⅢA期的144例患者(125例男性,19例女性;中位年龄60岁;范围41至80岁)。记录患者的人口统计学和临床特征、组织病理学诊断、正电子发射断层扫描-计算机断层扫描上肿块的标准化摄取值、肿瘤直径、手术类型、淋巴结转移状态、脏层胸膜侵犯以及总生存率和无病生存率等数据。

结果

中位生存期为39(范围27.8至46.1)个月,五年总生存率为28%。平均肿瘤直径为4.3±2.7 cm。中位无病生存期为37(范围28.1至48.6)个月,五年无病生存率为26.9%。在多因素分析中,T2N2M0亚组的总生存期和无病生存期显著差于其他亚组。其他生存不良预后因素包括肿瘤的标准化摄取值、全肺切除术以及非鳞状细胞癌和腺癌的组织病理学亚型。壁层胸膜侵犯与较差的无病生存率显著相关。

结论

我们的结果表明,在异质性肺癌阶段,由肿瘤组织病理学、淋巴结侵犯和手术类型所划分的亚组之间可能存在显著的生存差异。

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