Zhu Wenzhi, Zhu Liping, Wang Xiaoyi, Tan Hongyu
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Anesthesiology, Peking University Cancer Hospital & Institute, Beijing, 100142, People's Republic of China.
Department of Hospice Care, Peking University Cancer Hospital (Inner Mongolia Campus), Inner Mongolia, 010010, People's Republic of China.
Int J Gen Med. 2025 Jun 24;18:3347-3361. doi: 10.2147/IJGM.S524652. eCollection 2025.
This study investigated the impact of intraoperative dexamethasone on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) undergoing surgery.
Patients with NSCLC who underwent lung resection between January 1, 2006, and December 31, 2009, were included. Patients receiving dexamethasone formed the dexamethasone (DXM) group, while those who did not were assigned to the non-dexamethasone (non-DXM) group. Propensity score matching (PSM) was applied to minimize confounding bias. The primary endpoint was the incidence of postoperative complications.
Of the 579 patients included, 224 received intraoperative DXM, while 355 did not. PSM produced a matched cohort of 400 patients (200 in each group). After matching, the DXM group had significantly lower incidences of postoperative pneumonia (P < 0.05), reduced intensive care unit (ICU) ICU occupancy, and shorter postoperative hospital stays (PHS) compared with the non-DXM group (P < 0.05). No significant differences were observed in overall survival (OS) or recurrence-free survival (RFS) between the groups.
Intraoperative DXM use reduced the incidence of postoperative pneumonia, ICU occupancy, and PHS. However, no clear association was found between intraoperative DXM use and long-term survival outcomes in NSCLC patients.
本研究调查了术中使用地塞米松对接受手术的非小细胞肺癌(NSCLC)患者术后并发症和长期生存的影响。
纳入2006年1月1日至2009年12月31日期间接受肺切除术的NSCLC患者。接受地塞米松治疗的患者组成地塞米松(DXM)组,未接受地塞米松治疗的患者被分配到非地塞米松(non-DXM)组。应用倾向评分匹配(PSM)以尽量减少混杂偏倚。主要终点是术后并发症的发生率。
在纳入的579例患者中,224例接受了术中DXM治疗,355例未接受。PSM产生了一个由400例患者组成的匹配队列(每组200例)。匹配后,与non-DXM组相比,DXM组术后肺炎的发生率显著降低(P<0.05),重症监护病房(ICU)入住率降低,术后住院时间(PHS)缩短(P<0.05)。两组之间的总生存期(OS)或无复发生存期(RFS)未观察到显著差异。
术中使用DXM可降低术后肺炎的发生率、ICU入住率和PHS。然而,在NSCLC患者中,未发现术中使用DXM与长期生存结果之间存在明确关联。