肺癌生存分析：泰国一所非大学附属医院的 10 年真实临床经验（2012-2021 年）。

Survival Analysis of Lung Cancer: A 10-Year Real-Life Experience in a Non-University-Based Hospital in Thailand (2012-2021).

机构信息

Division of Pulmonology, Department of Medicine, Hatyai Medical Education Center, Hatyai Hospital, Songkhla, Thailand.

出版信息

Asian Pac J Cancer Prev. 2023 Sep 1;24(9):3021-3027. doi: 10.31557/APJCP.2023.24.9.3021.

DOI:10.31557/APJCP.2023.24.9.3021

PMID:37774053

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10762758/

Abstract

BACKGROUND

Over the past decades, several studies have mostly revealed that the overall survival among patients with lung cancer in university hospitals remained poor. However, the data on real-world treatments in non-university tertiary hospitals in Thailand still needs to be discovered. The primary objective was to assess the 10-year real-life overall survival among patients with lung cancer in a non-university hospital.

METHODS

A retrospective cohort study assessed patients diagnosed with lung cancer from a hospital-based lung cancer registry from January 2012 to December 2021 at Hatyai Hospital, Songkhla, Thailand. The demographic data and treatment outcomes were recorded. Kaplan-Meier methods were used for overall survival (OS), and a Log-rank test was used to compare the differences in survival based on different categories of prognostic factors. The prognostic factors for OS were assessed using a Cox-proportional hazard model.

RESULTS

Of 1,528 patients, the median age was 63.2± 12.1years; 1,009 (66%) were male; 981 (64%) had a history of smoking; 1,433 (93.7)% were non-small-cell lung cancer (NSCLC); 1,327 (87%) presented with stage IV disease. The median OS was 7.8 months for all patients, eight months for those with NSCLC, and 6.4 months for those with small cell lung cancer (SCLC). The 1-year, 3-year, and 5-year cumulative survival rates with all patients were 38%, 11%, and 6%. With NSCLC, 39%, 12%, and 6%, whereas for those with SCLC, 29%, 5%, and 4%, respectively. Disease stage III/IV and male gender were significantly associated with an increased risk of death, whereas receiving 1-2 line systemic treatments and curative surgical resection was a significant factor for survival in lung cancer patients.

CONCLUSION

In Thailand, the OS in patients with lung cancer has remained low over the decade. However, providing specific-lung cancer therapies and undergoing curative surgery remains a significant factor in improving their survival.

摘要

背景

在过去的几十年里，多项研究主要表明，大学医院的肺癌患者总体生存率仍然较差。然而，泰国非大学三级医院的真实治疗数据仍有待发现。主要目的是评估非大学医院肺癌患者的 10 年真实总生存率。

方法

回顾性队列研究评估了 2012 年 1 月至 2021 年 12 月在泰国宋卡府合艾医院基于医院肺癌登记处诊断为肺癌的患者。记录了人口统计学数据和治疗结果。采用 Kaplan-Meier 方法评估总生存率（OS），采用对数秩检验比较不同预后因素类别之间生存差异。采用 Cox 比例风险模型评估 OS 的预后因素。

结果

在 1528 名患者中，中位年龄为 63.2±12.1 岁；1009 名（66%）为男性；981 名（64%）有吸烟史；1433 名（93.7%）为非小细胞肺癌（NSCLC）；1327 名（87%）为 IV 期疾病。所有患者的中位 OS 为 7.8 个月，NSCLC 患者为 8 个月，小细胞肺癌（SCLC）患者为 6.4 个月。所有患者的 1 年、3 年和 5 年累积生存率分别为 38%、11%和 6%。NSCLC 患者分别为 39%、12%和 6%，SCLC 患者分别为 29%、5%和 4%。疾病 III/IV 期和男性是死亡风险增加的显著相关因素，而接受 1-2 线全身治疗和根治性手术切除是肺癌患者生存的显著因素。