原发性非小细胞肺癌及孤立转移灶患者综合治疗的预后观察

Effect of Comprehensive Treatment on the Prognosis of Patients with Primary Non-small Cell Lung Cancer with Solitary Metastasis

目的观察以外科治疗为主的综合治疗对原发性非小细胞肺癌伴远处孤立转移灶患者预后的作用.方法回顾性分析2005年2月至2008年3月期间42例经病理确诊的非小细胞肺癌患者,手术切除原发灶和在3月内出现孤立转移病灶的临床资料.比较非小细胞肺癌不同病理类型、原发肿瘤的T分期、术后淋巴结病理N分期、转移灶直径长轴及不同转移部位与预后的关系.结果生存时间及生存率:42例患者中位生存时间为17.1个月,1 a生存率、2 a生存率、5 a生存率分别为57.1%,38.0%,16.6%;原发肿瘤分期:T1+T2期患者预后明显好于T3+T4期患者(P<0.05);术后原发灶淋巴结分期:N0+N1期患者预后明显优于N2+N3期患者(P<0.05);转移灶直径:转移灶直径<25 mm预后好于转移灶直径>25 mm(P<0.05);病理类型:不同病理类型之间预后没有明显差别(P>0.05);转移部位:不同转移部位之间预后无明显差异(P>0.05).结论外科手术结合同期放化疗等综合治疗能延长NSCLC伴孤立转移灶患者生存期.

Objective To explore the prognosis of patients with primary non-small cell lung cancer(NSCLC)with solitary metastasis after cmprehensive treatment.Methods From Jun 2005 to Mar 2008,clinical data of 42 NSCLC patients with primary tumor and the solitary metastasis proved by pathology and treated by comprehensive treatment were retrospectively analyzed.The different pathological types of NSCLC,the T stage of primary tumor,the longitudinal axis diameter of metastatic lesion,the pathological N stage of lymph and the different metastasis sites were analyzed.Results The mean survival time in patients with NSCLC with solitary metastasis was 17.8 months.The 1-,3-,5-year survival rates of patients were 57.1%,38.0% and 16.6%,respectively.The survival rate of T1+T2 stage of primary tumor is hither than that of T2+T3 stage(P<0.05).The survival rate of N0+N1 pathological lymph stage was better than that of N2+N3 stage(P<0.05).The survival rate of patients with metastatic lesion diameter < 25 mm are higher than that of patients with metastatic lesion diameter >25 mm(P<0.05).There was no difference in prognosis between different pathology types and different metastasis sites.Conclusions Comprehensive treatment can prolong the survival time of patients with NSCLC and solitary metastasis.