Fiala P, Kubík A
Klinika pneumologie a hrudní chirurgie 3, LF UK, Praha.
Cas Lek Cesk. 1998 Apr 6;137(7):211-5.
The operability of lung cancer and the period of survival after resection of the lungs in our country does not yet attain the standard recorded in some advanced countries. The objective of the present work is to analyze factors which influence the survival period after resection therapy of lung cancer.
In 1985-90 in our department 496 patients were operated on account of lung cancer. This number comprised 31 patients subjected to explorative thoracototomy and three patients with pulmonary resection on account of a stage IIIb (pTNM) tumour who were excluded from the statistical analysis. The retrospective study proper analyzes the results of 462 patients (403 men and 59 women) operated in stages I, II and IIIa. Their mean age was 57 years (range 30-74 years, SD 7.5 years). The most frequent histological type was epidermoid carcinoma (68.8%), adenocarcinoma 18.2%, small-cell tumours 5.4% (25 patients). In 262 patients operated on account of lung cancer in stage I (pTNM) the probability of five-year survival was 49.2%, in patients in stage II 42.1%, in 158 patients in stage IIIa 20.9% (for all histological types combined). In 437 patients after resection of the lungs on account of non-small-cellular carcinoma the probability of five-year survival was as follows: stage I 50.0%, stage II 45.0%, stage IIIa 21.2%.
The probability of five-year survival for the whole group of 462 patients in stages I, II and IIIa was 38.8%. The most important factor which influenced the probability of five-year survival was the stage of the disease. Neither age nor sex of the patients nor the histological type of the tumour had a statistically significant effect on the probability of five-year survival.
我国肺癌的可切除性以及肺切除术后的生存期尚未达到一些发达国家所记录的标准。本研究的目的是分析影响肺癌切除治疗后生存期的因素。
1985 - 1990年,我科对496例肺癌患者进行了手术。其中包括31例行 exploratory thoracototomy(探查性开胸术)的患者以及3例因Ⅲb期(pTNM)肿瘤行肺切除术的患者,这3例患者被排除在统计分析之外。本回顾性研究实际分析了462例(403例男性和59例女性)接受Ⅰ、Ⅱ和Ⅲa期手术的患者结果。他们的平均年龄为57岁(范围30 - 74岁,标准差7.5岁)。最常见的组织学类型是鳞状细胞癌(68.8%),腺癌18.2%,小细胞肿瘤5.4%(25例患者)。在262例因Ⅰ期(pTNM)肺癌接受手术的患者中,五年生存率为49.2%,Ⅱ期患者为42.1%,158例Ⅲa期患者为20.9%(所有组织学类型合并计算)。在437例因非小细胞癌行肺切除术后的患者中,五年生存率如下:Ⅰ期50.0%,Ⅱ期45.0%,Ⅲa期21.2%。
462例Ⅰ、Ⅱ和Ⅲa期患者的五年生存率为38.8%。影响五年生存率的最重要因素是疾病分期。患者的年龄、性别以及肿瘤的组织学类型对五年生存率均无统计学上的显著影响。