Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300051, China.
Department of Thoracic Surgery, The First Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, 310003, China.
J Cancer Res Clin Oncol. 2023 Sep;149(11):8213-8223. doi: 10.1007/s00432-023-04729-8. Epub 2023 Apr 16.
Surgical resection is cornerstone treatment for early-stage non-small cell lung cancer (NSCLC) and offers a chance for cure. This study was conducted to determine current surgical treatment patterns and outcomes of Chinese patients with NSCLC.
Data of patients with histologically confirmed NSCLC of stages IA-IIIA and who underwent surgery between July 2014 and July 2020 were retrospectively collected from 9 tertiary hospitals in China. Cox model was used for multivariate analyses.
This study included 11,958 patients, among whom 59.1%, 19.2%, and 21.7% were in stages I, II, and IIIA, respectively. Lobectomy was the most common operation method (78.4%), followed by wedge resection (8.2%), segmentectomy (5.4%), pneumonectomy (5.2%), and bronchial sleeve lobectomy (2.8%). Among patients who underwent wedge resection and segmentectomy, majority had stage I NSCLC (87.2% and 93.3%, respectively), and sublobectomy accounted for 20.7% of stage I operations. With a median follow-up time of 30.2 months, disease-free survival (DFS) and overall survival (OS) rates of entire population were 88.9% and 96.1% at 1 year, 75.2% and 85.1% at 3 years, and 65.3% and 77.0% at 5 years, respectively. The 5-year OS rates for stages IA, IB, IIA, IIB, and IIIA disease were 93.2%, 82.7%, 70.3%, 67.0%, and 52.1%, respectively.
This is the largest real-world cohort study of patients with NSCLC who underwent surgery in China, where we described characteristics of surgical treatment and survival outcomes. The results of our study provide insights into real-world surgical treatment status for surgeons and clinicians.
手术切除是非小细胞肺癌（NSCLC）早期治疗的基石，为治愈提供了机会。本研究旨在确定中国 NSCLC 患者的当前手术治疗模式和结果。
回顾性收集了 2014 年 7 月至 2020 年 7 月期间在中国 9 家三级医院接受手术治疗的病理证实为 NSCLC 且分期为 IA-IIIA 的患者数据。采用 Cox 模型进行多变量分析。
本研究共纳入 11958 例患者，其中 59.1%、19.2%和 21.7%分别处于 I 期、II 期和 IIIA 期。肺叶切除术是最常见的手术方法（78.4%），其次是楔形切除术（8.2%）、节段切除术（5.4%）、全肺切除术（5.2%）和支气管袖状肺叶切除术（2.8%）。在接受楔形切除术和节段切除术的患者中，大多数为 I 期 NSCLC（分别为 87.2%和 93.3%），亚肺叶切除术占 I 期手术的 20.7%。中位随访时间为 30.2 个月，全人群的无病生存率（DFS）和总生存率（OS）分别为 1 年时的 88.9%和 96.1%、3 年时的 75.2%和 85.1%、5 年时的 65.3%和 77.0%。IA、IB、IIA、IIB 和 IIIA 期疾病的 5 年 OS 率分别为 93.2%、82.7%、70.3%、67.0%和 52.1%。
这是中国最大的 NSCLC 患者手术治疗的真实世界队列研究，描述了手术治疗和生存结果的特点。本研究结果为外科医生和临床医生提供了对真实世界手术治疗现状的深入了解。
