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背景与目的目前非小细胞肺癌(non-small cell lung cancer,NSCLC)仍是导致癌症死亡的首要原因,本研究旨在探讨影响晚期NSCLC预后的重要因素。方法收集2000年1月4日-2008年12月25日1,742例IV期NSCLC临床资料,所有病例经细胞学或组织病理学确诊。分析性别、年龄、吸烟史、病理类型、分型、临床TN分期、转移器官数目、治疗方法对预后的影响,应用Kaplan-Meire方法计算生存率,Log-rank检验生存率差别,采用Cox多因素回归对预后因素进行分析。结果本组1,742例患者的中位生存期为10.0个月(9.5个月-10.5个月),1年、2年、3年、4年、5年生存率分别为44%、22%、13%、9%、6%。单器官发生转移与多器官转移中位生存期分别为11个月vs7个月(P<0.001)。不同器官发生转移后生存期不同,中位生存期分别为肺12个月(11.0个月-12.9个月),骨9个月(8.3个月-9.6个月),脑8个月(6.8个月-9.1个月),肝、肾上腺、远处淋巴结转移均为5个月(3.8个月-6.1个月),皮下3个月(1.7个月-4.3个月)。腺癌患者1,086例(62%),鳞癌305例(17.5%),中位生存期分别为12个月vs8个月(P<0.001)。化疗与最佳支持治疗者中位生存期分别为11个月vs6个月(P<0.001)。放疗与否的中位生存期分别为11个月vs9个月(P=0.017)。结论性别、年龄、大体分型、病理类型、临床T分期、N分期、转移器官数目、吸烟史、治疗方法是晚期NSCLC预后的独立影响因素。
BACKGROUND & OBJECTIVE: Non-small cell lung cancer (NSCLC) is still the leading cause of cancer death. The purpose of this study is to investigate the important factors affecting the prognosis of advanced NSCLC. Methods A total of 1,742 patients with stage IV NSCLC from January 4, 2000 to December 25, 2008 were collected. All cases were confirmed by cytology or histopathology. The gender, age, smoking history, pathological type, classification, clinical TN staging, number of metastatic organs and treatment methods were analyzed. Kaplan-Meire method was used to calculate the survival rate and Log-rank test. Regression analysis of prognostic factors. Results The median survival of 1,742 patients in this group was 10.0 months (9.5 months -10.5 months). The 1, 2, 3, 4 and 5 year survival rates were 44%, 22% and 13% %, 9%, 6%. The median single-organ metastasis and multi-organ metastasis survival were 11 months vs 7 months (P <0.001). The survival of different organs after the transfer of different survival rates were 12 months lung (11.0 months -12.9 months), bone 9 months (8.3 months -9.6 months), brain 8 months (6.8 Month-9.1 months), liver, adrenal, and distant lymph node metastases for 5 months (3.8 months to 6.1 months) and 3 months (1.7 months to 4.3 months) subcutaneously. 1,086 cases of adenocarcinoma (62%) and 305 cases of squamous cell carcinoma (17.5%) had a median survival of 12 months vs 8 months (P <0.001). Median survival was 11 months vs 6 months (P <0.001) for chemotherapy and best supportive care, respectively. Median survival was 11 months vs. 9 months (P = 0.017), respectively. Conclusion The gender, age, general classification, pathological type, clinical stage T, stage N, number of metastatic organs, smoking history and treatment are independent prognostic factors of advanced NSCLC.