Lymph node type as a prognostic factor for survival in T2 N1 M0 non-small cell lung carcinoma
Lymph node type as a prognostic factor for survival in T2 N1 M0 non-small cell lung carcinoma
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DOI：
10.1016/s0003-4975(97)00089-1
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发表时间：
1997-05-01
影响因子：
4.6
通讯作者：
vandenBosch, JMM
中科院分区：
文献类型：
--
作者：
vanVelzen, E;Snijder, RJ;vandenBosch, JMM
背景。 II 期非小细胞肺癌患者的 5 年生存率各不相同。研究了特定类型淋巴结受累对生存的影响。方法。对 1977 年至 1993 年期间接受手术的 2,009 名患者中的 391 名患有病理性 T2 N1 M0 疾病的患者进行了回顾。 N1 状态通过直接扩展或通过肺叶或肺门淋巴结转移而细化为淋巴结受累。结果。所有医院幸存者 (n = 369) 的累积 5 年生存率为 37.8%。肺叶转移患者的 5 年生存率优于肺门转移患者（57.3% 比 30.3%；p = 0.0028）和淋巴结直接转移患者（57.3% 比 39.1%；p = 0.03）。肺门转移患者和直接扩展患者的生存率没有差异。内脏胸膜受累患者、腺癌患者和 60 岁以上患者的生存率明显较差。生存率与性别、切除类型、中心生长或肿瘤大小无关。结论。根据淋巴结受累的类型，生存率有所不同：叶淋巴结转移似乎是疾病的早期阶段，而肺门淋巴结转移则代表更晚期的形式。然而，在 T2 N1 M0 疾病中，除了淋巴结状态之外的其他因素似乎也在术后生存中发挥着重要作用。 (C) 1997 年，胸外科医师协会。
Background. Patients with stage II non-small cell lung carcinoma represent a group with varying 5-year survival rates. The influence of specific types of lymph node involvement on survival was investigated.Methods. Of 2,009 patients operated on from 1977 through 1993, the cases of 391 patients with pathologic T2 N1 M0 disease were reviewed. The N1 status was refined into lymph node involvement by direct extension or by metastases in lobar or hilar lymph nodes.Results. The cumulative 5-year survival rate of all hospital survivors (n = 369) was 37.8%. The 5-year survival rate of patients with lobar metastases was superior to that of patients with hilar metastases (57.3% versus 30.3%; p = 0.0028) and that of patients with lymph node involvement by direct extension (57.3% versus 39.1%; p = 0.03). The survival rate did not differ between those with hilar metastases and those with direct extension. Survival was significantly poorer in patients with visceral pleural involvement, in patients with adenocarcinoma, and in patients older than 60 years. Survival was not related to sex, type of resection, central growth, or tumor size.Conclusions. Survival differs according to the type of lymph node involvement: lobar lymph node metastasis seems to be an early stage of the disease, whereas hilar lymph node metastasis represents a more advanced form. However, in T2 N1 M0 disease, other factors besides nodal status also seem to play an important role in postoperative survival. (C) 1997 by The Society of Thoracic Surgeons.