208例手术切除的ⅢA-N_2期非小细胞肺癌患者的生存分析

Survival and prognostic factors in completely resected ⅢA-N_2 non-small cell lung cancer:208 cases study

目的探讨完整切除术后ⅢA-N2期非小细胞肺癌(NSCLC)的预后因素。方法对2000年1月至2004年12月中山大学肿瘤防治中心收治的208例手术切除ⅢA-N2期NSCLC患者进行单因素生存分析和多因素分析。结果 208例手术切除的ⅢA-N2期NSCLC患者的中位生存期为769 d,1、2、3、4、5年的累计生存率分别为80.1%、55.2%、36.6%、29.2%和20.9%。利用Cox比例风险模型进行多因素分析发现术前血清癌胚抗原(CEA)、乳酸脱氢酶(LDH)水平和术后是否行辅助放、化疗是影响预后的独立因素。结论术前血清CEA、LDH水平和术后是否行辅助放、化疗是影响预后的重要因素。

Objective To investigate clinical prognostic factors of completely resected stage ⅢA-N2 non-small cell lung cancer （NSCLC）. Methods Proceeding survival analysis of 208 pathological Stage ⅢA-N2 NSCLC patients with completely resection in Cancer center of Sun Yatsen University from Jan 2000 to Dec 2004. Prognostic factors were estimated with Kaplan-Meier and logrank analysis. Using Cox regression model to evaluate the influence of factors on the survival. Results Median survival time for this patient population was 769 days and 1,2,3,4,5-year overall survival were 80.1 %,55.2%, 36.6 %, 29.2 % and 20.9 %. Univariate analysis identified 5 significant prognostic clinical factors including age,preoperative serum CEA and LDH elevation,postoperative chemotherapy, numbers of postoperative chemotherapy cycles. Postoperative radiotherapy and anemia were marginally significant. In multivariate analysis,4 independent prognostic factors entered the model： preoperative serum CEA and LDH elevation,postoperative chemotherapy and radiotherapy. Conclusion Preoperative serum CEA elevation,preoperative serum LDH elevation,postoperative chemotherapy and radiotherapy have the prognostic significance in postoperative stage ⅢA-N2 NSCLC.