手术切除对于Ⅱ～ⅢA期小细胞肺癌患者的预后影响  

Impact of surgical resection on stage Ⅱ-ⅢA small-cell lung carcinoma patients ' prognosis

作　　者：闫琰[1] 刘曦光 蔡开灿[1] 吴华[1] 蔡瑞君[1] 刁定伟[1] 

机构地区：[1]南方医科大学附属南方医院胸心血管外科,广州市510515

出　　处：《实用医学杂志》2016年第12期1959-1962,共4页The Journal of Practical Medicine

基　　金：吴阶平医学基金会资助项目(编号:320.6799.15008)

摘　　要：目的：探讨手术切除对Ⅱ～ⅢA期小细胞肺癌患者的预后影响。方法：回顾性分析2009年1月1日至2014年2月1日收治的Ⅱ～ⅢA期小细胞肺癌患者资料，分为行手术切除联合术后辅助放化疗患者（试验组）23例和未行手术切除患者（对照组）23例。首先使用倾向评分匹配两组病例，然后用Kaplan-Meier生存分析统计其无进展生存时间（progression-free survival， PFS）和总生存时间（overall survival，OS），并用Fisher确切概率法对1年和2年生存率进行检验，Cox 回归进行多因素分析。结果：PFS 和 OS 高于对照组（P ＜0．05）。手术切除是影响预后的独立因素（P ＜0．05）。结论：可根治性手术的Ⅱ～ⅢA期小细胞肺癌患者手术切除疗效能够延长患者的无进展生存时间及总生存时间。Objective To investigate the impact of surgical resection on patients with Ⅱ-Ⅲ A stage small cell lung carcinoma （SCLC）. Method Data of 61 in-patients who diagnosed as Ⅱ-ⅢA stage SCLC from Jan 1st 2009 to Feb 1st 2014 were analyzed. 23 patients underwent surgical resections were enrolled as the treatment group, while 38 patients without surgical resection were enrolled as the control group. Disease progression was confirmed by monthly examination. The grouping is balanced by propensity score match. The progression-free survival （PFS） time and overall survival（OS） were analyzed with Kaplan-Meier survival method and Cox regression is applied to analyze the covariates. Fisher＇s exact test was applied to compare one-year survival rate and two-year survival rate. Results The PFS and OS of the treatment group is longer than that of the control group （P 〈 0.05）. Both one-year and two-year survival rates of the treatment group outnumber those of the control group （P 〈 0.05）. Cox regression indicates that surgical resection is an independent prognostic factor （P 〈 0.05）. Conclusion Surgical resection on tolerable patients with stage Ⅱ-Ⅲ A small-cell lung carcinoma is effective on improving the progression-free survival time,one-year and two-year survival rates,and also shows a propensity of a higher overall survival time.

关 键 词：小细胞肺癌 复合型小细胞肺癌 外科手术 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]