Survival After Surgery for Pathologic Stage IA Non-Small Cell Lung Cancer Associated With Idiopathic Pulmonary Fibrosis
Survival After Surgery for Pathologic Stage IA Non-Small Cell Lung Cancer Associated With Idiopathic Pulmonary Fibrosis
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DOI：
10.1016/j.athoracsur.2011.06.055
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发表时间：
2011-11-01
影响因子：
4.6
通讯作者：
Hoshi, Eishin
中科院分区：
文献类型：
--
作者：
Saito, Yuichi;Kawai, Yasuyuki;Hoshi, Eishin
背景肺癌合并特发性肺纤维化（IPF）患者的治疗存在许多问题，但很少有研究探讨此类患者肺切除术后的长期预后。本研究的目的是确定病理分期IA的非小细胞肺癌（NSCLC）和IPF患者的术后生存率。我们回顾性分析了1994年9月至2007年12月期间在我们机构接受肺切除术的350例病理分期为IA的NSCLC患者。我们分析并比较了其中28例同时患有肺癌和IPF的患者与其余322例无IPF的肺癌患者。病理分期IA肺癌伴IPF患者的5年生存率为54.2%，而无IPF患者的5年生存率为88.3%（p < 0.0001）。单因素分析显示，年龄、性别、Brinkman指数、有限切除、手术时间、腺癌和IPF是影响生存率的重要预后因素（p < 0.10）。然而，通过多变量分析，只有IPF是生存的重要预后因素（p = 0.007）。倾向评分匹配分析证实只有IPF是显著的预后因素（p = 0.043）。病理IA期NSCLC和IPF患者的5年生存率为54.2%。IPF对接受肺切除术治疗的病理学IA期NSCLC患者的生存率具有独立的不良影响。(Ann Thorac Surg 2011; 92：1812-8）（C）2011年，胸外科医师协会
Background. Many problems exist in regard to the treatment of lung cancer patients with idiopathic pulmonary fibrosis (IPF), but few reported studies have investigated the long-term prognosis after pulmonary resection in such patients. The purpose of the present study was to determine the postoperative survival of patients with pathologic stage IA non-small cell lung cancer (NSCLC) and IPF.Methods. We retrospectively reviewed 350 patients with pathologic stage IA NSCLC who underwent pulmonary resections at our institution between September 1994 and December 2007. We analyzed and compared 28 of these patients, who had simultaneous lung cancer and IPF, with the remaining 322 lung cancer patients without IPF.Results. The 5-year survival rates were 54.2% in pathologic stage IA lung cancer patients with IPF and 88.3% in those without IPF (p < 0.0001). Univariate analyses showed that age, sex, Brinkman Index, limited resection, operation time, adenocarcinoma, and IPF were significant prognostic factors for survival (p < 0.10). By multivariate analysis, however, only IPF was a significant prognostic factor for survival (p = 0.007). Propensity score-matching analysis confirmed that only IPF was significant prognostic factor (p = 0.043).Conclusions. The 5-year survival rate of patients with pathologic stage IA NSCLC and IPF is 54.2%. IPF has independent, adverse effects on survival of pathologic stage IA NSCLC patients treated with pulmonary resection. (Ann Thorac Surg 2011; 92: 1812-8) (C) 2011 by The Society of Thoracic Surgeons