Jefferson M F, Pendleton N, Faragher E B, Dixon G R, Myskow M W, Horan M A
University Department of Geriatric Medicine, University Hospital of South Manchester.
Br J Cancer. 1996 Aug;74(3):456-9. doi: 10.1038/bjc.1996.381.
Many factors have been individually related to outcome in populations of non-small-cell lung cancer (NSCLC) patients. Factors responsible for the outcome of an individual after surgical resection are poorly understood. We have examined the importance of 'tumour volume' in determining prognosis of patients following resection of NSCLC in a multivariate model. Cox's proportional hazard analysis was used to determine the relative prognostic significance of stage, patient age, gender, tumour cell-type, nodal score and estimated 'tumour volume' in 669 cases with NSCLC treated with surgical resection, of which 280 had died. All factors (except tumour cell-type, P = 0.33) were individually related to survival (P < 0.05). When examined together, survival time was significantly and independently related to 'tumour volume' and stage (P < 0.001), and other factors ceased to be significant. In cases with stage I or II tumours, risk of death was found to increase significantly with increasing estimated 'tumour volume' (23.8% relative increase in hazard to death per doubling of 'tumour volume', 95% confidence interval 13.2-35.2%, P < 0.001 stage I; P < 0.006 stage II). In cases with stage IIIa tumours this factor alone was the significant prognostic variable. In conclusion, an estimate of 'tumour volume' significantly improves prediction of prognosis for individual NSCLC patients with UICC stage I or II tumours.
许多因素已分别与非小细胞肺癌（NSCLC）患者群体的预后相关。对于手术切除后个体患者预后的相关因素，目前了解甚少。我们在一个多变量模型中研究了“肿瘤体积”在NSCLC切除术后患者预后判定中的重要性。采用Cox比例风险分析来确定在669例接受手术切除的NSCLC患者中，分期、患者年龄、性别、肿瘤细胞类型、淋巴结评分和估计的“肿瘤体积”的相对预后意义，其中280例患者已经死亡。所有因素（除肿瘤细胞类型外，P = 0.33）均分别与生存率相关（P < 0.05）。当综合考虑时，生存时间与“肿瘤体积”和分期显著且独立相关（P < 0.001），而其他因素不再具有显著性。在I期或II期肿瘤患者中，发现死亡风险随估计的“肿瘤体积”增加而显著增加（“肿瘤体积”每增加一倍，死亡风险相对增加23.8%，95%置信区间为13.2 - 35.2%，I期P < 0.001；II期P < 0.006）。在IIIa期肿瘤患者中，仅这一因素就是显著的预后变量。总之，对“肿瘤体积”的估计显著改善了对国际抗癌联盟（UICC）I期或II期肿瘤的NSCLC个体患者预后的预测。
