真实世界中老年非小细胞肺癌的临床特征及预后分析

Clinical features and prognostic factors of elderly non-small cell lung cancer patients in real-life clinical practice

目的:探讨真实世界中老年非小细胞肺癌患者的临床特点及预后因素。方法:回顾性分析我院肿瘤科、胸外科、呼吸科及老年病科2015年6月至2017年6月出院的老年非小细胞肺癌患者的临床资料742例,利用SPSS 17. 0软件进行统计学处理,K-M法进行单因素分析,Log-rank法评价生存差异,COX多因素回归模型对多个变量分析确定影响预后的因素,检验水准为α=0. 05,分别探讨了性别、年龄、体能状态(ECOG)、临床分期、病理类型、合并症、治疗方式等7个因素对预后的影响。结果:我中心老年非小细胞肺癌男女性别比例为3. 7∶1,单因素分析显示年龄、病理类型、ECOG评分、临床分期、治疗方式及合并症是影响预后的危险因素,多因素分析显示病理类型、ECOG评分、临床分期、治疗方式及合并症是影响预后的独立危险因素。结论:我中心老年非小细胞肺癌患者男女比例稍高,性别、年龄对生存期无显著影响,而病理为腺鳞癌、ECOG评分高、临床分期晚、合并症多及姑息治疗方式是预后不佳的独立危险因素。

Objective:To explore the clinical features and prognostic factors of elderly patients with non-small cell lung cancer in real-life.Methods:The clinical data of 742 patients with non-small cell lung cancer(NSCLC)who were discharged from our hospital from June 2015 to June 2017,including Oncology,Thoracic Surgery,Respiratory Department and Geriatric Department,were retrospectively analyzed.SPSS 17.0 software was used to carry out statistical analysis with K-M method and Log-rank method was used to evaluate survival difference.COX multivariate regression model was used to determine the prognostic factors of multiple variables.The test level wasα=0.05.Gender,age,physical condition(ECOG),clinical stage,pathological type,complication and treatment were studied respectively.Results:The gender ratio of male and female in elderly non-small cell lung cancer in our center was 3.7∶1.Univariate analysis showed that age,pathological type,ECOG,clinical stage,treatment style and complications were risk factors for prognosis,and multivariate analysis showed pathological type,ECOG,clinical stage,treatment style and complications were risk factors for prognosis.Conclusion:The male and female ratio of elderly patients with NSCLC in our center is slightly higher than that of young patients.Gender and age have no significant influence on survival,but adenosquamous carcinoma,high ECOG score,late clinical staging,multiple complications and palliative treatment are independent risk factors for poor prognosis.