Survival analysis of completely resected stage ⅢB non-small cell lung cancer

Abstract

ⅢB期即T4/N3非小细胞肺癌多已不能手术治愈,但可完全切除的ⅢB期患者能否从手术及术后辅助治疗中获益成为人们关注的焦点。本文回顾分析我院自1997年1月1日至2001年4月30日完全切除的51例ⅢB期原发性非小细胞肺癌的肿瘤特征,以及术后辅助治疗对其生存的影响。方法 对51例完全切除术后病理证实为ⅢB期原发性非小细胞肺癌进行回顾性分析,探讨疾病的临床特征如性别、组织学类型、肿瘤分化、T分期、淋巴结状态及术后化疗、放疗对生存的影响。结果 不同性别（Logrank=0.992,P=0.319）、组织学类型（Logrank=1.263,P=0.260）、分化程度（Logrank=1.104,P=0.577）、T分期（Logrank=0.106,P=0.588）、淋巴结状态（Logrank=1.297,P=0.731）及术后纵隔放疗（Logrank=0.482,P=0.488）、术后辅助化疗（Logrank=0.051,P=0.759）未能明显延长完全切除术后ⅢB期的NSCLC中位生存期及提高生存率。结论 不同的性别、病理类型、肿瘤分化、T分期、N分期对ⅢB期NSCLC完全切除术后的生存无影响,术后化疗及纵隔放疗未能改善患者的预后。

Background and objective Most stage ⅢB （T4/N3） non-small cell lung cancer （NSCLC） can not be cured via operation, but how is the outcome for those with T4 or occasionally N3 which can be completely resected? This paper retrospectively analyses the effects of the tumor characteristics and postoperative treatments on the survival of 51 patients with stage ⅢB NSCLC completely resected in this hospital from January 1, 1997 to April 30, 2001. Methods The effects of clinical pathophysiological characteristics such as gender, histological type, differentiation, T-stage and lymph node status and the postoperative chemotherapy or radiotherapy on the prognosis of 51 patients with completely resected stage ⅢB NSCLC were retrospectively analysed. Results There were no statistic survival differences in the disease characteristics such as the different gender （Log rank=0.992, P=0.319）, histological types （Log rank=1.263, P=0.260）, differentiation （Log rank=1.104, P=0.577）, T-stage （Log rank=0.106, P=0.588） and lymph node status （Log rank=1.297, P=0.731）, also no difference between groups whether or not there was postoperative mediastinal radiotherapy （Log rank=0.482, P=0.488） or postoperative chemotherapy （Log rank=0.051, P=0.759）. Conclusion Neither the tumor characteristics such as gender, histological type, differentiation, T-stage and N-stage, nor the postoperative mediastinal radiotherapy or chemotherapy affect the survival of stage ⅢB NSCLC with complete resection.