Ye Jiayue, Liu Jiacong, Ma Yucheng, Wang Yiqing, Xia Pinghui, Lv Wang, Hu Sheng, Hu Jian
Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Thoracic Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
J Thorac Dis. 2025 Jul 31;17(7):4439-4472. doi: 10.21037/jtd-2025-445. Epub 2025 Jul 28.
Lung cancer is a leading cause of cancer-related deaths globally, with a particularly high burden in China and a poor prognosis mainly due to late-stage diagnosis and limited effective treatments. Large-sample survival analyses are lacking for patients with lung cancer who nodules of present with same-lobe, multi-lobe, or mixed nodules, as well as those with multiple separate nodules. This study aimed to assess the survival rates of patients with lung cancer by focusing on overall survival and disease-specific survival.
A large dataset of 166,097 patients with lung cancer was obtained from the Surveillance, Epidemiology, and End Results database. Survival analyses, including univariate, multivariate, and stratified analyses, and survival curves, were conducted using Empower Stats, SPSS 24, and GraphPad. Eight covariates, including age, sex, and race, were adjusted.
Compared to patients with a single-tumor, those with same-lobe nodules, multi-lobe nodules, or mixed-distribution nodules had a significantly increased mortality risk. Furthermore, stratified analysis indicated that, compared to patients with a single-tumor, the increase in mortality risk was substantially greater among patients who underwent surgical treatment than among those who did not receive surgery.
Patients with lung cancer who have satellite nodules located in the same-lobe or in different lobes on the same side as the primary tumor have a significantly higher mortality risk than those with single tumors. Surgical intervention in these patients further increases this risk.
肺癌是全球癌症相关死亡的主要原因，在中国负担尤为沉重，且预后较差，主要是由于诊断较晚和有效治疗有限。对于出现同叶、多叶或混合结节以及多个独立结节的肺癌患者，缺乏大样本生存分析。本研究旨在通过关注总生存期和疾病特异性生存期来评估肺癌患者的生存率。
从监测、流行病学和最终结果数据库中获取了一个包含166,097例肺癌患者的大型数据集。使用Empower Stats、SPSS 24和GraphPad进行生存分析，包括单变量、多变量和分层分析以及生存曲线分析。对年龄、性别和种族等八个协变量进行了调整。
与单肿瘤患者相比，具有同叶结节、多叶结节或混合分布结节的患者死亡风险显著增加。此外，分层分析表明，与单肿瘤患者相比，接受手术治疗的患者死亡风险增加幅度明显大于未接受手术的患者。
与单肿瘤患者相比，原发性肿瘤同侧同叶或不同叶有卫星结节的肺癌患者死亡风险显著更高。对这些患者进行手术干预会进一步增加这种风险。
