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220例完全切除Ⅱ期非小细胞肺癌术后患者的生存分析

Survival analysis of 220 patients with completely resected stage-II non-small cell lung cancer

摘要Background and Objective: Surgery is the main therapy for patients with stage-ll non-small cell lung cancer (NSCLC), but patients still have an unsatisfactory prognosis even though complete resection is usually possible. Adjuvant chemotherapy provides low rates of clinical benefit as well. We retrospectively analyzed prognostic factors of patients with completely resected stage-ll NSCLC to find patients with unfavorable factors for proper management. Methods: Clinical data of 220 patients with complete resections of stage-ll NSCLC at the Sun Yat-sen University Cancer Center between January 1998 and December 2004 were retrospectively analyzed. Cumulative survival was analyzed by the Kaplan-Meier method and compared by log rank test. Prognosis was analyzed by the Cox proportional hazards model. Results: The overall 3- and 5-year survival rates were 58.8% and 47.9%, respectively. The 3- and 5-year disease-free survival rates were 45.8% and 37.0%, respectively. Of the 220 patients, 86 (39.1%) had recurrence or metastasis. A univariate analysis demonstrated that age (> 55 years), blood type, the presence of symptoms, chest pain, tumor volume (> 20 cm3), total number of removed lymph nodes (≥10), number of involved N1 lymph nodes (≥3 ), total number of removed N2 lymph nodes (> 6), and the ratio of involved N1 lymph nodes (≥35%) were significant prognostic factors for 5-year survival. In the multivariate analysis, age (> 55 years), chest pain, tumor volume (> 20 cm3), total number of removed lymph nodes (≥10), and number of involved N1 lymph nodes (≥ 3) were independent prognostic factors for 5-year survival. Conclusions: For patients with completely resectable stage-ll NSCLC, having > 55 years, presenting chest pain, tumor volumes > 20 cm3, and ≥ 3 involved N1 lymph nodes were adverse prognostic factors, and ≥ 10 removed lymph nodes was a favorable one. Patients with poor prognoses might be treated by individual adjuvant therapy for better survival.

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作者 戴云 [1] 苏晓东 [1] 龙浩 [1] Peng Lin [1] Jian-Hua Fu [1] Lan-Jun Zhang [1] Xin Wang [1] Zhe-Sheng Wen [1] Zhi-Hua Zhu [1] Xu Zhang [1] Tie-Hua Rong [1] 学术成果认领
作者单位 State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China;Lung Cancer Research Center, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China [1]
分类号 R73
栏目名称 Original Article
发布时间 2010-07-05
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2010年29卷5期

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