70岁以上老年肺癌患者预后多因素分析

Multivariate analysis of prognostic factors in geriatric lung cancer patients aged 70 and over

目的:探讨影响70岁以上老年肺癌患者预后生存的危险因素。方法:随访分析62例70岁以上肺癌患者临床资料,计算改良老年疾病累计评分表(MCIRS-G)评分,得到总分(TSC)、严重指数(SV)和合并症指数(CM)。应用单因素分析及COX多因素回归模型分析确定影响预后的因素。结果:62例患者中位生存期为30.52个月,82.26%伴有合并症,TSC、CM、SV与年龄增长正相关(r依次为0.656、0.739、0.677,P均<0.05)。单因素分析显示年龄、病理类型、临床分期、美国东部肿瘤协作组(ECOG)评分、分化程度、手术、TSC、CM、SV与预后相关(P均<0.05)。COX多因素分析显示临床分期、ECOG评分、分化程度、手术、TSC、CM、SV是影响患者生存及预后的独立因素。结论:临床分期、分化程度、合并症、ECOG评分、手术是老年肺癌独立预后因子。MCIRS-G能有效评估合并症对老年肺癌患者预后的影响。

This study aimed at evaluating the survival of patients older than 70 with lung cancer and explore the independent prognostic factors in this group of patients. METHODS：The modified cumulative illness rating scale-geriatric（MCIRS-G） was scored for a cohort of elderly patients with lung cancer. Total score （TSC）,severity index（SV） and comorbidity index（CM） were obtained. Clinical features were also used. All patients underwent a follow-up for mortality. Univariate analysis and multivariate analysis were used to identify factors associated with prognosis in the enrolled patients. RESULTS：The overall median survival was 30.52 months and the incidence of complications was 82.26%. TSC,SV and CM were positively correlated with age（r were 0.656,0.739 and 0.677,respectively,P〈0.05）. By univariate analysis,age,pathological type,clinical stages,American Eastern Cooperative Oncology Group（ECOG） performance status （PS）,differentiation degree,surgery,TSC,SV and CM were significantly related to prognosis and survival in geriatric lung cancer patients（P〈0.05）. By multivariable analysis,clinical stages,ECOG PS,differentiation degree,surgery,TSC,SV and CM were independent prognostic factors. CONCLUSION：Clinical stages,differentiation degree,comorbidity,ECOG PS and surgery may be independent prognostic factors in the elderly with lung cancer. The MCIRS-G could effectively assess the influence of comorbidities on the prognosis of lung cancer in this patient group.