Background and objective: Thoracic surgery hasn't got consensus on therapy of pIIIa/N2 non-small cell lung cancer (NSCLC). The aim of this study is to identify prognostic factors in NSCLC with N2 nodal involvement.
Methods: A retrospective review of disease free survival and 5-year survival for NSCLC patients who underwent primary surgical resection without neoadjuvant chemotherapy was performed. Between January 1998 and May 2004, 133 patients were enrolled. Several factors such as age, sex, skip metastasis, number of N2 lymph node stations, type of resection, histology and adjuvant therapy were recorded and analyzed. SPSS 16.0 was used for calculating survival.
Results: Overall 5-year survival for 133 patients was 32.33%, and 5-year survival for single N2 station and multiple N2 station sub-group were 39.62% and 27.50%, respectively. 5-year survival for cN0-1 and cN2 sub-group were 37.78% and 20.93%, respectively. Cox regression analysis revealed that number of N2 station (P=0.013, OR=0.490, 95%CI: 0.427-0.781) and cN status (P=0.009, OR=0.607, 95%CI: 0.372-0.992) were two favorable prognostic factors of survival.
Conclusion: Number of N2 station and cN status are two favorable prognostic factors of survival. In restrict enrolled circumstances, after combined therapy made up of surgery and postoperative adjuvant therapy have been performed, satisfied survival can be achieved.
背景与目的: 目前对pⅢa/N2期非小细胞肺癌患者所采取的治疗方法尚不一致。本研究旨在评价不同影响因素与pⅢa/N2非小细胞肺癌患者预后的相关性。
方法: 回顾性分析1998年1月-2004年5月133例非小细胞肺癌患者经以外科干预为主的综合治疗后的无瘤生存期和5年生存率。研究因素包括年龄、性别、跳跃转移、淋巴结转移站数、手术类型、病理分型、辅助治疗等。应用SPSS 16.0软件统计生存率。
结果: 133例pⅢa/N2期入组患者总的5年生存率为32.33%，单站淋巴结转移亚组与多站淋巴结转移亚组的5年生存率分别为39.62%和27.50%；临床N0-1分期（cN0-1）亚组与临床N2分期（cN2）亚组的5年生存率分别为37.78%和20.93%。Cox回归分析显示：淋巴结转移站数（P=0.013, OR=0.490, 95%CI: 0.427-0.781）及cN0-1（P=0.009, OR=0.607, 95%CI: 0.372-0.992）与N2患者预后呈正相关。
结论: 非小细胞肺癌的cN分期、淋巴结转移站数目与pⅢa/N2期患者的预后呈正相关；在严格入组条件下，可以对选择性pⅢa/N2患者进行以外科治疗为主、联合辅助治疗的综合治疗，并可获得较满意的长期生存率。