基于SEER数据库的肿瘤直径大于7.0厘米的非小细胞肺癌患者预后分析

Prognosis Analysis of Non-small Cell Lung Cancer with Diameter over 7.0 cm Based on SEER Database

目的区分肿瘤直径>7.0 cm的非小细胞肺癌(NSCLC)患者死亡风险,评估手术及非手术治疗的临床价值。方法基于SEER数据库收集2010—2015年肿瘤直径>7.0 cm非小细胞肺癌患者数据。寿命表法计算1、2、3年生存率,Kaplan-Meier法绘制生存曲线,单因素及多因素Cox回归模型分析预后影响因素。结果纳入的5519例患者1、2、3年累计生存率分别为51.8%、33.0%、25.0%。单因素、多因素Cox回归分析显示肿瘤大小、淋巴结N分期、治疗方式是影响NSCLC的预后独立危险因素(P<0.001)。结论N0~N1期肿瘤直径>7.0 cm非小细胞肺癌患者,手术治疗有利于患者生存预后。N2期肿瘤直径7.0~9.0 cm组,手术治疗在改善患者预后方面存在优势。N2期肿瘤直径≥9.0 cm组以及N3期患者手术与非手术患者预后方面差异未见统计学意义。姑息治疗不能改善患者预后。

Objective To analyze the mortality risk and evaluate the curative effects of surgery and nonsurgery on NSCLC with diameter>7.0 cm.Methods We collected the data of NSCLC patients with diameter>7.0 cm from 2010 to 2015 from the SEER database.The 1,2,3-year survival rates were analyzed by life table method.Overall survival curve was estimated by Kaplan-Meier method.Univariate and multivariate Cox regression models were used to analyze the independent prognostic factors.Results The 1,2,3-year survival rates were 51.8%,33.0%and 25.0%,respectively.In univariate and multivariate analyses,tumor size,N stage and treatment were the independent prognostic factors(P<0.001).Conclusion Surgery is benefited for the prognosis of stage N0-N1 NSCLC patients with diameter>7.0 cm.And for stage N2 NSCLC patients with diameter 7.0-9.0 cm,surgical treatment has advantages in improving the prognosis.Surgical and non-surgical patients with tumor diameter≥9.0 cm or lymph node N3 stage have no statistically significant differences in prognosis.In addition,palliative treatment does not improve the prognosis of patients.