摘要
目的 基于国际抗癌联盟的肺癌ＴＮＭ９７ 分期，探讨影响非小细胞肺癌分期和生存的因素。方法 采集１９６９ 年４ 月～１９９３ 年１２ 月的１ ７５７ 例连续手术病例（ 包括完全性切除病例、减量切除病例和单纯剖胸探查病例），随访至１９９８ 年１１ 月３０ 日。用ＳＰＳＳ统计软件包的ＫａｐｌａｎＭｅｉｅｒ 和Ｃｏｘ模型进行生存分析。结果 全组病例完全失访３０ 例，失访率１．７１％ 。５ 年累积生存率ⅠＡ 期８８．０ ％ ，ⅠＢ 期５３ ．９％ ，Ⅱ期３３．５％ ，ⅢＡ 期１４．７％ ，ⅢＢ 期５．５％ ，Ⅳ期７．０％ ，总５ 年生存率２８．２ ％ 。５ ，１０ 年生存率在完全性手术组分别为３９－８ ％ 和３１．４ ％ ，减量性手术组为１４．４ ％ 和９ ．５％ ，剖胸探查术组为４ ．２％ 和０ ％ 。对长期累积生存率的影响程度，依次为手术性质、淋巴结状况、９７ 分期、原发肿瘤大小和病理类型。结论 ９７ 分期在各期的终点疗效同一性和分期特异性上优于修订前的８６ 分期，但需对Ｔ３ Ｎ１ Ｍ０ 的分期归属和Ｍ１
Objective To study the factors affecting post operative staging and survival in non small cell lung cancer (NSCLC) patients based on the revised TNM staging system adopted by the UICC in 1997. Methods Data were collected from 1757 consecutively operated NSCLC patients, including those receiving complete tumor excision, tumor debulking and exploratory thoracotomy from April 1969 through Dec. 1993. The end point of follow up was Nov. 30, 1998. Cumulative survival and its influencing factors were analyzed by Kaplan Meier and Cox model of SPSS software.Results In this series, 30 patients (1.71%) were lost from follow up. The 5 year cumulative survival rate was 88.0% for patients in stageⅠ A, 53.9% in stage Ⅰ B, 33.5% in stage Ⅱ, 14.7% in stage Ⅲ A, 5.5% in stage Ⅲ B and 7.0% in stage Ⅳ. The overall 5 year survival rate was 28.2%. The 5 year survival rate was 39.8%, 14.4% and 4.2% in patients treated with complete tumor resection, tumor debulking and exploratory thoracotomy, respectively. The 10 year survival rate was 31.4%, 9.5% and 0%, respectively. Factors affecting long term cumulative survival, in the order of decreasing significance, were the type of operation, lymph node status, staging, size and pathologic type of the primary tumor.Conclusion The revised staging system for NSCLC is superior to that used since 1986 as far as the end results of treatment in patients in different stage and the staging specificity are concerned. The T 3N 1M 0 classification and the definition of M 1 need to be further studied.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
1999年第5期363-365,共3页
Chinese Journal of Oncology
基金
广东省科委重点攻关项目基金
关键词
肺肿瘤
肿瘤分期
生存率
非小细胞肺癌
Lung neoplasms/surgery Neoplasms staging Survival analysis Carcinoma, non small cell lung/surgery
