手术是改善Ⅲ-N2期非小细胞肺癌患者总生存期的一种有前景的策略。
Surgery is a promising strategy for improving overall survival for stage III-N2 non-small cell lung cancer patients.
作者信息
Yang Jie, Jiang Chao, Wang Yue, Qiu Rong, Su Jingwei, Liu Changjiang, Jing Li
机构信息
Department of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Chest Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
出版信息
J Thorac Dis. 2023 Mar 31;15(3):1426-1432. doi: 10.21037/jtd-23-269. Epub 2023 Mar 28.
BACKGROUND
Surgery is commonly used to treat stage I lung cancer patients, whereas radiotherapy is applied to treat stage III lung cancer patients. However, few advanced-stage lung cancer patients benefit from surgery. This study aimed to investigate the efficacy of surgery for stage III-N2 non-small cell lung cancer (NSCLC) patients.
METHODS
A total of 204 patients with stage III-N2 NSCLC were included and divided into surgery (n=60) and radiotherapy (n=144) groups. The clinical characteristics [tumor node metastasis (TNM) stage, and adjuvant chemotherapy] and basic information (gender, age, and smoking/family history) of the included patients were evaluated. Furthermore, the patients' Eastern Cooperative Oncology Group (ECOG) scores and comorbidities were also evaluated, and the Kaplan-Meier approach was utilized to analyze their overall survival (OS). A multivariate Cox proportional hazards model was generated to analyze OS.
RESULTS
There was a significant difference in disease stages (IIIa and IIIb) between the surgery and radiotherapy groups (P<0.001). Compared with the surgery group, there were more patients with ECOG scores of 1 and 2 and fewer patients with ECOG scores of 0 in the radiotherapy group (P<0.001). Moreover, there was a significant difference in comorbidities between the stage III-N2 NSCLC patients in the two groups (P=0.011). The OS rate was higher significantly in stage III-N2 NSCLC patients in the surgery group compared to that in the radiotherapy group (P<0.05). Kaplan-Meier analysis demonstrated that the OS of III-N2 NSCLC was markedly better in the surgery group compared to the radiotherapy group (P<0.05). The multivariate proportional hazards model showed that age, T stage, surgery, disease stage, and adjuvant chemotherapy were independent prognostic predictors for OS in stage III-N2 NSCLC patients.
CONCLUSIONS
Surgery is associated with improved OS in stage III-N2 NSCLC patients and is recommended to treat these patients.
背景
手术常用于治疗I期肺癌患者，而放疗则用于治疗III期肺癌患者。然而，很少有晚期肺癌患者能从手术中获益。本研究旨在探讨手术治疗III-N2期非小细胞肺癌（NSCLC）患者的疗效。
方法
共纳入204例III-N2期NSCLC患者，分为手术组（n=60）和放疗组（n=144）。评估纳入患者的临床特征[肿瘤淋巴结转移（TNM）分期和辅助化疗]以及基本信息（性别、年龄和吸烟/家族史）。此外，还评估了患者的东部肿瘤协作组（ECOG）评分和合并症，并采用Kaplan-Meier法分析其总生存期（OS）。生成多变量Cox比例风险模型以分析OS。
结果
手术组和放疗组在疾病分期（IIIa和IIIb）方面存在显著差异（P<0.001）。与手术组相比，放疗组中ECOG评分为1和2的患者更多，而ECOG评分为0的患者更少（P<0.001）。此外，两组III-N2期NSCLC患者在合并症方面存在显著差异（P=0.011）。手术组III-N2期NSCLC患者的OS率显著高于放疗组（P<0.05）。Kaplan-Meier分析表明，手术组III-N2期NSCLC的OS明显优于放疗组（P<0.05）。多变量比例风险模型显示，年龄、T分期、手术、疾病分期和辅助化疗是III-N2期NSCLC患者OS的独立预后预测因素。
结论
手术可改善III-N2期NSCLC患者的OS，建议用于治疗这些患者。
Zotero 插件