1秒用力呼气量与可手术非小细胞肺癌无复发生存率之间的关联：一项采用倾向评分重叠加权的前瞻性队列研究
Association between forced expiratory volume in 1 s and relapse-free survival in operable non-small cell lung cancer: a prospective cohort study with propensity score overlap weighting.
作者信息
Wu Shaoping, Fu Siqian, Ripley-Gonzalez Jeffrey William, Cui Ni, Du Yang, Sylvester Karl, You Baiyang, Xu Ning, Cheng Jing, Dun Yaoshan, Liu Suixin
机构信息
Division of Cardiac Rehabilitation, Department of Physical Medicine & Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, Hunan, China.
出版信息
BMJ Open. 2024 Dec 20;14(12):e085076. doi: 10.1136/bmjopen-2024-085076.
OBJECTIVES
Investigate the correlation between the percentage of predicted forced expiratory volume in 1 s (FEV1%pred) and survival outcomes, namely relapse-free survival (RFS) and overall survival (OS), in patients diagnosed with operable early-stage non-small cell lung cancer (NSCLC).
DESIGN
Prospective observational study.
SETTING
Clinical settings in Xiangya Hospital, Central South University, Hunan, China.
PARTICIPANTS
From November 2014 to December 2019, 775 operable patients with NSCLC, median age 58 years (IQR 13) with 40.6% women, were consecutively enrolled and underwent preoperative FEV1 assessment. All participants were evaluated using the FEV1%pred assessment. Subsequent treatments and operative interventions followed established protocols for NSCLC.
RESULTS
During the follow-up, which lasted a median of 40 months (range 1-85 months) and continued until December 2021, 202 patients either relapsed or died. Optimal FEV1%pred cut-off was identified using receiver operating characteristic analysis. Results revealed 110 and 71 relapses and deaths per 1000 person-years for patients with FEV1 values of <82%pred and ≥82%pred, respectively. Cox proportional hazards models, adjusted for demographics, medical history and surgery characteristics with propensity score overlap weighting, revealed the significant impact of lower FEV1%pred on decreased RFS and OS. An FEV1%pred less than 82% displayed a significant association with decreased RFS (weighted HR, 1.55; 95% CI, 1.14 to 2.09; p=0.007) and OS (weighted HR, 1.50; 95% CI, 1.01 to 2.23; p=0.04).
CONCLUSIONS
Lower FEV1%pred values notably correlate with compromised RFS and OS in individuals operable for early-stage NSCLC, suggesting that FEV1%pred may serve as a valuable tool in evaluating and managing long-term recurrence risk in patients with early-stage NSCLC.
TRIAL REGISTRATION NUMBER
ChiCTR2100048120.
目的
研究1秒用力呼气容积占预计值百分比（FEV1%pred）与可手术切除的早期非小细胞肺癌（NSCLC）患者生存结局，即无复发生存期（RFS）和总生存期（OS）之间的相关性。
设计
前瞻性观察性研究。
地点
中国湖南中南大学湘雅医院临床科室。
参与者
2014年11月至2019年12月，连续纳入775例可手术切除的NSCLC患者，中位年龄58岁（四分位间距13），女性占40.6%，并进行术前FEV1评估。所有参与者均采用FEV1%pred评估。后续治疗和手术干预遵循既定的NSCLC治疗方案。
结果
在中位持续时间为40个月（范围1 - 85个月）且持续至2021年12月的随访期间，202例患者复发或死亡。使用受试者工作特征分析确定最佳FEV1%pred临界值。结果显示，FEV1值<82%pred和≥82%pred的患者每1000人年分别有110例和71例复发及死亡。采用倾向得分重叠加权法对人口统计学、病史和手术特征进行校正的Cox比例风险模型显示，较低的FEV1%pred对RFS和OS降低有显著影响。FEV1%pred低于82%与RFS降低（加权HR，(1.55)；95%CI，(1.14)至(2.09)；(p = 0.007)）和OS降低（加权HR，(1.50)；95%CI，(1.01)至(2.23)；(p = 0.04)）显著相关。
结论
较低的FEV1%pred值与可手术切除的早期NSCLC患者RFS和OS受损显著相关，提示FEV1%pred可作为评估和管理早期NSCLC患者长期复发风险的有价值工具。
试验注册号
ChiCTR2100048120 。
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