Clinical factors and prognosis in non-small cell lung cancer
Clinical factors and prognosis in non-small cell lung cancer
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DOI：
10.1097/00000421-199910000-00006
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发表时间：
1999-10-01
影响因子：
2.6
通讯作者：
Pereira, JR
中科院分区：
文献类型：
--
作者：
Martins, SJ;Pereira, JR
我们评估了在巴西接受治疗的1,635例非小细胞肺癌（NSCLC）患者的临床特征与生存率的关系。以下变量包括：性别、年龄、吸烟、Karnofsky体力状态（PS）、体重减轻、诊断时的症状（咳嗽、呼吸困难、咯血、胸痛、喘息和声音嘶哑）、是否存在上级腔静脉综合征（SVCS）、组织学类型、TNM分期和治疗方式（手术、化疗[CT]和放疗[RT]）。采用考克斯回归分析获得多因素预后模型。不适合手术或有复发疾病的患者选择进一步RT和/或CT，该组的长期结果与仅手术治疗组相当。细支气管肺泡癌的诊断、小肿瘤、无声音嘶哑、手术治疗和RT是I期和II期良好总生存率的独立相关因素。体重减轻和SVCS的临床体征与III期预后不良有关。PS、腺癌或未分化癌的诊断、无体重减轻和呼吸困难、NO或N1疾病、接受RT、CT和进行一些姑息性手术的能力是IV期的良好预后因素。诊断时NSCLC患者的临床特征为估计其预后提供了额外的信息。
We evaluated the relationship of clinical characteristics and survival in 1,635 patients with non-small cell lung cancer (NSCLC) treated in Brazil. The following variables were included: sex, age, smoking, Karnofsky's performance status (PS), weight loss, symptoms at diagnosis (cough, dyspnea, hemoptysis, chest pain, wheezing, and hoarseness), presence of superior vena cava syndrome (SVCS), histologic type, TNM stage, and therapeutic modality (surgery, chemotherapy [CT] and radiotherapy [RT]). Multivariate prognostic models were obtained by Cox regression. Patients unsuitable for surgery or who had recidivant disease were elected to further RT and/or CT, and long-term results in this group were equivalent to those in the group treated only by surgery. A diagnosis of bronchioloalveolar carcinoma, small tumors, absence of hoarseness, treatment by surgery, and RT were independent factors related to good overall survival in stage I and II. Weight loss and clinical signs of SVCS were related to poor prognosis in stage III. PS, diagnosis of adenocarcinoma or undifferentiated carcinoma, absence of weight loss and dyspnea, NO or N1 disease, ability to receive RT, CT, and to perform some palliative surgical procedure were good prognostic factors in stage IV. Clinical features of patients with NSCLC at diagnosis offer additional information to estimate their prognosis.