Caballero-Vázquez Alberto, Romero-Béjar José Luis, Albendín-García Luis, Suleiman-Martos Nora, Gómez-Urquiza José Luis, Cañadas Gustavo Raúl, Cañadas-De la Fuente Guillermo Arturo
Diagnostic Lung Cancer Unit, Broncopleural Techniques and Interventional Pulmonology Departament, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
Department of Statistics and Operational Research, University of Granada, Avda Fuentenueva, E-18071 Granada, Spain.
J Clin Med. 2021 Feb 1;10(3):519. doi: 10.3390/jcm10030519.
Lung cancer is typically diagnosed in an advanced phase of its natural history. Explanatory models based on epidemiological and clinical variables provide an approximation of patient survival less than one year using information extracted from the case history only, whereas models involving therapeutic variables must confirm that any treatment applied is worse than surgery in survival terms. Models for classifying less than one year survival for patients diagnosed with lung cancer which are able to identify risk factors and quantify their effect for prognosis are analyzed.
Two stepwise binary logistic regression models, based on a retrospective study of 521 cases of patients diagnosed with lung cancer in the Interventional Pneumology Unit at the Hospital "Virgen de las Nieves", Granada, Spain.
The first model included variables age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain. The independent risk factors age greater than 70 years, a peripheral location, dyspnea and dysphonia were significant. For the second model, treatments were also significant.
Age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain are predictors for survival in patients diagnosed with lung cancer at the time of diagnosis. The treatment applied is significant for classifying less than one year survival time which confirms that any treatment is markedly inferior to surgery in terms of survival. This allows to consider applications of more or less aggressive treatments, anticipation of palliative cares or comfort measures, inclusion in clinical trials, etc.
肺癌通常在其自然病程的晚期被诊断出来。基于流行病学和临床变量的解释模型仅使用从病历中提取的信息，对患者生存期不到一年的情况提供了一个近似估计，而涉及治疗变量的模型必须确认所应用的任何治疗在生存期方面都比手术差。分析了用于对肺癌患者生存期不到一年进行分类的模型，这些模型能够识别危险因素并量化其对预后的影响。
基于对西班牙格拉纳达“拉斯涅韦斯圣母医院”介入肺病科521例肺癌确诊患者的回顾性研究，建立了两个逐步二元逻辑回归模型。
第一个模型包括年龄、肺部肿瘤病史、肿瘤位置、呼吸困难、声音嘶哑和胸痛等变量。独立危险因素为年龄大于70岁、外周位置、呼吸困难和声音嘶哑。对于第二个模型，治疗方法也具有显著性。
年龄、肺部肿瘤病史、肿瘤位置、呼吸困难、声音嘶哑和胸痛是肺癌确诊患者诊断时生存期的预测因素。所应用的治疗方法对于分类生存期不到一年具有显著性，这证实了任何治疗在生存期方面明显不如手术。这使得可以考虑应用或多或少积极的治疗方法、预期姑息治疗或舒适措施、纳入临床试验等。
