Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer
Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer
复制标题
DOI：
10.1378/chest.117.6.1568
复制
发表时间：
2000-06-01
期刊：
影响因子：
9.6
通讯作者：
Goodman, PC
中科院分区：
文献类型：
--
作者：
Patz, EF;Rossi, S;Goodman, PC
目的：探讨IA期非小细胞肺癌(非小细胞肺癌)患者肿瘤大小与生存时间的关系。方法：对1981~1999年间收治的510例病理类型为IA期(T1N0M0)的非小细胞肺癌患者进行研究。男285例，女225例，年龄31~90岁，平均63岁。用COX比例模型检验其对生存的影响。肿瘤大小作为线性效应和类别变量被纳入模型。使用Kaplan-Meier乘积极限估计器以图形方式显示肿瘤大小与生存之间的关系。结果：Cox比例风险模型未显示肿瘤大小与生存之间的线性效应(p=0.701)。然后将肿瘤大小分为四分位数，两组之间的存活率也没有统计学上的显著差异(p=0.597)。肿瘤大小也按十进制分类，肿瘤大小与生存期之间无统计学关系(p=0.674)。结论：本研究证实了IA期非小细胞肺癌患者在同一肿瘤分期中，生存期无明显差异。不幸的是，这些数据警告说，用筛查CT改进小结节检测可能不会显著提高肺癌死亡率。适当的前瞻性随机试验似乎是合理的。
Objective: The purpose of this study was to determine the relationship between tumor size and survival in patients with state IA non-small cell lung cancer (non-small cell lung cancer; ie, lesions < 3 cm).Method: Five hundred ten patients with pathologic stage IA (T1N0M0) non-small cell lung cancer were identified from our tumor registry over an 18-year period (from 1981 to 1999). There were 285 men and 225 women, with a mean age of 63 years (range, 31 to 90 years). The Cox proportional model was used to examine the effect on survival. Tumor size was incorporated into the model as a linear effect and as categorial variables. The Kaplan-Meier product limit estimator was used to graphically display the relationship between the tumor size and survival.Results: The Cox proportional hazards model did not show a statistically significant relationship between tumor size and survival (p = 0.701) as a linear effect. Tumor size was then categorized into quartiles, and again there was no statistically significant difference in survival between groups (p = 0.597). Tumor size was also categorized into deciles, and there was no statistical relationship between tumor size and survival (p = 0.674).Conclusions: This study confirms stratifying patients with stage IA non-small cell lung cancer in the same TNM classification, given no apparent difference in survival. Unfortunately, these data caution that improved small nodule detection with screening CT may not significantly improve lung cancer mortality. The appropriate prospective randomized trial appears warranted.