Spirometry at diagnosis and overall survival in non-small cell lung cancer patients.
Spirometry at diagnosis and overall survival in non-small cell lung cancer patients.
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DOI：
10.1002/cam4.4808
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发表时间：
2022-12
期刊：
影响因子：
4
通讯作者：
Christiani, David C.
中科院分区：
文献类型：
--
作者：
Zhai, Ting;Li, Yi;Brown, Robert;Lanuti, Michael;Gainor, Justin F.;Christiani, David C.
肺功能可以预测全因死亡率，慢性阻塞性肺疾病（COPD）与非小细胞肺癌（NSCLC）患者较差的总生存期（OS）相关。虽然术前肺功能可预测肺癌手术后住院死亡率，但其对长期生存的预测效用尚不清楚。常用肺活量测定法在肺癌患者生存中的预后作用仍不确定。本研究评估肺量测定在肺癌诊断中预测非小细胞肺癌患者生存期的作用。这是一项回顾性研究，使用来自波士顿肺癌研究的数据，对新诊断的非小细胞肺癌患者在癌症治疗前进行肺活量测定（n = 2805）。肺活量测定值在使用四分位数进行分类后，使用单变量和风险调整多元回归模型分析其与OS的相关性。此外，我们通过肺活量测定法确定的COPD状态来分析OS，并且在COPD患者中，通过全球慢性阻塞性肺疾病倡议标准定义的分期来分析OS。单变量和多元回归模型均表明，肺癌诊断时1秒用力呼气量和用力肺活量的实际和预测百分比较低的四分位数与较差的OS显著相关。肺活量测定法确定的COPD和肺癌诊断时COPD的晚期与更差的肺癌OS相关。研究结果表明，诊断时良好的肺功能可能有助于改善非小细胞肺癌患者的OS。肺功能与肺癌手术后住院死亡率相关，但肺功能在非小细胞肺癌患者长期生存中的预测作用尚不清楚。我们基于一个大型肺癌队列的分析显示，诊断时肺活量测定功能较低的非小细胞肺癌患者的总生存期较差。这笔资金为在非小细胞肺癌患者的长期风险分层中开始肺癌治疗前评估肺功能提供了证据。
Pulmonary function can predict all‐cause mortality, and chronic obstructive pulmonary disease (COPD) is associated with worse overall survival (OS) in non‐small cell lung cancer (NSCLC) patients. Though pre‐operative lung function is predictive of in‐hospital mortality following lung cancer surgery, its predictive utility for long‐term survival is unclear. The prognostic role of commonly used spirometry tests in survival of lung cancer also remains uncertain. This study evaluates the role of spirometry at lung cancer diagnosis in predicting OS of NSCLC patients. This was a retrospective study using data from the Boston Lung Cancer Study on newly diagnosed NSCLC patients with spirometry tests performed before cancer therapy (n = 2805). Spirometric test values, after being categorized using quartiles, were analyzed for association with OS using univariate and risk‐adjusted multiple regression models. Further, we analyzed OS by the status of COPD determined by spirometry, and, among those with COPD, by its stage defined by the Global Initiative for Chronic Obstructive Lung Disease criteria. Both univariate and multiple regression models demonstrated that lower quartiles of actual and percent predicted forced expiratory volume in 1 second and forced vital capacity at lung cancer diagnosis were significantly associated with worse OS. Spirometry‐determined COPD, and more advanced stage of COPD at lung cancer diagnosis were associated with worse lung cancer OS. The findings provide evidence that a good pulmonary function at diagnosis may help improve OS in NSCLC patients. Lung function has been associated with in‐hospital mortality following lung cancer surgery but the predictive role of lung function in long‐term survival of NSCLC patients remains unclear. Our analyses, based on a large lung cancer cohort, revealed that NSCLC patients with lower spirometry function at diagnosis were associated with worse overall survival. The funding provides evidence for evaluating lung function before the initiation of lung cancer therapy in the long‐term risk stratification of NSCLC patients.
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影响因子：
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作者：
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通讯作者：
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影响因子：
3.4
作者：
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DOI：
10.1007/978-1-4419-6646-9_5
发表时间：
2012-01-01
期刊：
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影响因子：
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作者：
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通讯作者：
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影响因子：
45.3
作者：
Heist, Rebecca Suk;Zhai, Rihong;Christiani, David C.
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影响因子：
5.8
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Buist S