高龄肺癌外科治疗预后影响因素分析  

Analysis of prognostic factors of old surgical-treated non-small cell lung cancer

作　　者：杨冉[1] 王长利[1] 张真发[1] 岳东升[1] 

机构地区：[1]天津医科大学肿瘤医院肺部肿瘤科,天津300060

出　　处：《天津医科大学学报》2008年第1期94-97,共4页Journal of Tianjin Medical University

摘　　要：目的:分析手术方式、辅助化疗等因素对70岁以上高龄非小细胞肺癌(NSCLC)患者预后的影响。方法:回顾性研究238例70岁以上行手术治疗的NSCLC患者,分析性别、吸烟史、术前肺功能、肿瘤大小、手术方式、淋巴结清除数目、病理类型、TNM分期、气管断端有无残留、辅助化疗等对高龄NSCLC预后的影响。结果:肿瘤直径大于3cm、TNM分期、淋巴结清除个数为该组患者的预后独立危险因素;楔形切除及肺叶切除术预后好于全肺切除术(P=0.032);辅助化疗组与单纯手术组5年生存率差异无统计学意义(P=0.139)。结论:对于早期高龄NSCLC,术中需在彻底切除肿瘤的前提下尽可能保留肺功能;系统性清除纵隔及肺门淋巴结有利于提高生存率。辅助化疗未明显改善本组患者5年生存率。Objective： To assess the effect of the operation modality, adjuvant chemotherapy and other factors on the prognosis of non-small cell lung cancer （NSCLC） in patients over 70. Methods： We retrospectively analyzed 238 NSCLC patients of 70 years or older underwent curative surgical treatment. The relationship between prognosis and clinical characteristics, such as sex, smoking habits, preoperative PFTs, primary tumor size, modus operandi, number of resected lymphnode, pathological type, TNM stage, incised margin residual, adjuvant chemotherapy, were evaluated in this study. Results： Tumor size more than 3 cm, TNM stage, the resected lymphnodes number were independent prognosis factors. The patients who underwent wedge resection and lobectomy had a better prognosis than those who underwent pneumonectomy （P =0.032 ）. There was no significant difference of 5 year survival rate between adjuvant chemotherapy and non-adjuvant chemotherapy（P =0.139）o Conclusion： To advanced aged NSCLC cases who are still operable, we should try to reserve the lung function in the premise of thorough resection. Adjuvant chemotherapy can＇ t significantly improve the overall 5 year survival rate in this group.

关 键 词：肺肿瘤 外科手术治疗 高龄 预后 

分 类 号：R734.2[医药卫生—肿瘤]