1523例非小细胞肺癌外科治疗的多因素预后分析

Multivarite Prognosis Analysis of Surgical Treatment on 1523 Patients with Non-small-cell Lung Cancer

目的总结分析外科治疗非小细胞肺癌的多种相关预后因素,以规范非小细胞肺癌的治疗和提高其远期疗效。方法对1991年至2003年我院手术治疗的1523例非小细胞肺癌回顾性临床分析。结果1523例NSCLC中502例I期的5年生存率55.03%,378例II期41.24%,598例III期19.23%,45例IV期肺癌4.36%,689例NO肺癌的5年生存率49.97%,401例N1的23.18%,406例N2的18.44%,27例N3无5年生存,1年生存率仅21.82%,992例鳞癌的5年生存率42.97%,403例腺癌的26.32%,差异显著(P<0.01)。结论分期因素,尤其是N因素和病理类型是肺癌预后的最重要相关因素,综合治疗尤其是新辅助化疗有新的前景。

Objective To conclude relative factors that influence prognosis in order to standardize the treatment and improve the therapeutic effect of surgery on primary non - small cell lung cancer. Methods A retrospective analysis was performed according to clinical data on 1523 patients with primary non - small cell lung cancer undergoing operation in Liaoning Tumor Hospital between Aug. 1991and Aug. 2003, and 5 - year survival rate was calculated by Kaplan - Meier method. Results Over all 5 -＇year survival kate was as follows： stage Ⅰ 55. 03%, Ⅱ41.24%,Ⅲ 19. 23%, Ⅳ 4. 36% and NO 49. 97% , N1 23. 18%, N2 18.44%, N3 0%. There was no obvious relations among age, sex, postoperative chemotherapy and prognosis （ all P 〉 0. 05 ）, while there was obvious relations among pathological type, pathological stage, surgery mode and prognosis. Conclusions Operation is the primary treatment for non - small cell lung cancer. Pathological type, pathological stage and surgery mode are important factors concerned non - small cell lung cancer. Comprehensive treatment, especially the auxiliary treatment shows a bright outlook.