全胸腔镜肺叶切除术对早期非小细胞肺癌远期生存率的影响及预后相关因素  

Long Term Survival Rate of of Video-assisted Thoracoscopic Lobectomy Versus Open Lobectomy for Non-small Cell Lung Cancer and Its Prognostic Factors

作　　者：郑江敏[1] 高文华[2] 李栋[1] 李立彬[1] 

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院胸外科,河北邢台054000 [2]冀中能源邢台矿业集团有限责任公司总医院骨科,河北邢台054000

出　　处：《医学综述》2015年第23期4363-4365,共3页Medical Recapitulate

摘　　要：目的探讨全胸腔镜肺叶切除术对早期非小细胞肺癌（NSCLC）远期生存率的影响及其预后相关因素。方法选择2009年5月至2010年5月冀中能源邢台矿业集团有限责任公司总医院收治的48例NSCLC患者为研究对象，按照手术方式不同分为观察组和对照组，各24例。观察组采用全胸腔镜下肺叶切除术，对照组行常规开胸手术。比较两组患者手术一般情况、3年生存率及中位生存期；分析患者手术相关资料，采用Cox回归模型分析影响患者预后的风险因素。结果观察组手术时间、术中出血量、住院时间显著少于对照组[（221±37）min比（252±45）min，（328±58）mL比（542±64）mL，（9±3）d比（13±5）d]（P〈0．01），两组间清扫淋巴结数比较差异无统计学意义（P〉0．05）；观察组和对照组并发症发生率[12．5％（3／24）比16．7％（4／24）]、局部复发率[4．2％（1／24）比8．4％（2／24）]比较差异亦无统计学意义（P〉0．05）。全部患者随访1～36个月，中位随访时间18．9个月；观察组3年生存率为58．3％，中位生存期为23个月；对照组为50．0％。中位生存期为19个月，两组患者3年生存率比较差异无统计学意义（P〉0．05）。多因素分析显示，肿瘤直径（OR=1．624，95％CI1．201～2．071）、术后放化疗（OR=1．549，95％CI1．113～2．141）是影响NSCLC患者预后的主要因素。结论对于早期NSCLC，全胸腔镜肺叶切除术是一种安全、有效的手术方式；影响患者预后的主要因素有肿瘤直径、术后放化疗。Objective To explore the long term survival rate and its prognostic factors of of video-assisted thoracoscopic lobectomy versus open lobectomy for non-small cell lung cancer （NSCLC）. Methods A total of 48 cases of non-small cell lung cancer patients admitted to the General Hospital of Jizhong Energy Xingtai Mining Group Co. ,Ltd from May 2009 to May 2010 were divided into observation group of 24 cases and control group of 24 cases. The observation group received complete thoracoscopic lobectomy, and the control group underwent conventional open chest operation. The general situation of operation, 3-year survival rate and median survival time of the two groups were compared ; the clinical data and the risk factors affecting the prognosis were analyzed by Cox regression model. Results The operation time, bleeding volume, length of hospital stay of the observation group were significantly less than that of the control group [ （ 221 ± 37 ） minvs （252±45） min,（328±58） mLvs （542±64） mL,（9±3） dvs （13±5） d] （P〈0.01）,the number of lymph node dissection in the two groups had no significant differences（ P 〉 0. 05 ）. The incidenee of complications[ 12.5% （3/24） vs 16. 7% （4/24） ] , local recurrenee rate[4.2% （1/24） vs 8.4% （2/ 24 ） ] of the two groups had no statistically significant differences（ P 〉 0.05 ）. All patients were followed up for 1-36 months, the median follow-up time was 18.9 months;the 3-year survival rate of the observation group was 58.3% ,the median survival time was 23 months; of the control group was 50% ,the median survival time was 19 months, and the 3-year survival rate of the two groups had no significant difference（ P 〉 0.05 ）. Multivariate analysis showed that tumor diameter （ OR = 1. 624,95 % CI 1. 201-2.071 ）, and postoperative radiotherapy and chemotherapy （ OR = 1. 549,95 % CI 1.113-2. 141 ） were the main factors influencing the prognosis of NSCLC patients. Conclusion For early stage NSCLC, thoracoscopic lobectomy i

关 键 词：非小细胞肺癌 全胸腔镜肺叶切除术 远期生存率 预后 

分 类 号：R734[医药卫生—肿瘤]