肺癌脑转移瘤的手术治疗效果及其预后因素分析

Surgical management and prognostic factors of brain metastases from lung cancer

目的探讨肺癌脑转移瘤(BM)的手术治疗效果及其预后影响因素。方法回顾性分析北京天坛医院神经外科2013年1月—2018年12月手术治疗的123例肺癌脑转移瘤患者的临床资料。分析患者的生存时间及独立预后影响因素。结果本组患者术后的中位生存时间为22个月;1年、2年生存率分别为73.2%和35.8%。单因素分析显示,肺癌是否颅外转移、脑转移瘤的深浅部位、肺癌脑转移瘤的病理类型及脑转移瘤切除程度对患者的生存期有明显影响(P<0.05~0.001)。多因素Cox回归分析显示,肺癌是否颅外转移、脑转移瘤的深浅部位和转移瘤切除程度是影响患者预后的独立因素。结论肺癌脑转移瘤手术治疗能明显延长患者的生存期,而有肺癌颅外转移、深部脑转移瘤和转移瘤部分切除的患者预后较差。

Objective To investigate the surgical effects and prognosis factors for the treatment of brain metastasis(BM)from lung cancer.Methods The clinical data of 123 patients with BM from lung cancer underwent operation between January 2013 and December 2018,in Beijing Tiantan Hospital,were analyzed retrospectively.The survival time and independent prognostic factors were analyzed.Results The postoperative median survival time for patients with BM from lung cancer was 22 months.The 1-year and 2-year survival rates were 73.2%and 35.8%respectively.Univariate analysis showed that extracranial metastasis,depth of BM,pathology of BM and resection degree of BM were factors that affected the survival of patients with BM from lung cancer.Cox regression analysis showed that extracranial metastasis,depth of BM and resection degree of BM were factors that affected the survival of patients with BM from lung cancer.Conclusions Surgical treatment of brain metastases from lung cancer can significantly prolong the survival time of patients.The prognosis of patients with extracranial metastasis of lung cancer,deep BM and partial resection of metastatic tumor is poor.