非小细胞肺癌同侧肺内转移术后预后因素分析

Prognosis of ipsilateral intrapulmonary metastasis in resected non-small cell lung cancer

目的探讨原发性非小细胞肺癌(NSCLC)同侧肺内转移外科手术的疗效及预后因素。方法对46例经手术病理证实并行完全切除的原发性非小细胞肺癌同侧肺内转移的病例进行回顾性研究,分为与原发肿瘤灶同叶的肺内转移(pm1)22例和不同叶的肺内转移(pm2)24例二组。结果本组病例总的3年生存率为47.8%,中位生存期(MST)为34.3个月,pm1的3年生存率为63.6%,MST为48个月。pm2的3年生存率为33.3%,MST为24个月。pm1和pm2的3年生存率有统计学差异(P=0.0215)。并分析了患者的生存率与一些临床病理因素的关系(病理类型、肺转移结节数、淋巴结分期)。其中N0的3年生存率为68.8%,与N1-33年生存率为36.7%比较有显著差异(P=0.0175)。结论肺内转移灶与原发灶同叶和不同叶、有无淋巴结转移是影响非小细胞肺癌肺内转移术后预后的重要因素。

Objective To explore the prognostic implications of intrapulmonary metastasis （pm） in resected non- small cell lung cancer （NSCLC）. Methods Forty-six patients with intrapulmonary metastasis in NSCLC had received complete surgical resection with lymphadenectomy. They were classified into 22 pm patients within the same lobe as the primary tumour （pm1） and 24 patients within another lobe to that containing the primary tumour （pm2）. Results The overall survival of pm patients was 47.8% at 3 - years and MST was 34. 3 months. The 3- year survival rate of pm1 was 63.6%, but that of pm2 was 33.3%. MSTof pm1 was 48 months and that of pm2 was 24 months. We evaluated the various clinicopathological factors （tumor histology, number of pm and N factor）. The 3 - year survival of NO group was 68.8% and that of N1 - 3 group was 36.7%. A statistically significant difference between the two groups was identified （P = 0. 0175）. Conclusion The analysis shows that pm1 or pm2 , nodal involvement are both the most influential factors to the prognosis of NSCLC with intrapulmonary metastasis.