Comprehensive study of prognostic risk factors of patients underwent pneumonectomy.
Comprehensive study of prognostic risk factors of patients underwent pneumonectomy.
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全肺切除术患者预后危险因素综合研究
DOI：
10.7150/jca.19454
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发表时间：
2017
影响因子：
3.9
通讯作者：
Chen H
中科院分区：
文献类型：
--
作者：
Gu C;Wang R;Pan X;Huang Q;Luo J;Zheng J;Wang Y;Shi J;Chen H
目的：探讨肺切除术后并发症及影响预后的危险因素。方法：对406例肺切除术患者进行了研究。对所有患者的年龄、性别、吸烟史、手术治疗情况、术后并发症、肿瘤分期及随访情况等临床病理资料进行分析。结果：30天和90天死亡率分别为3.2%和6.2%。术后并发症149例（36.7%），主要为心律失常、输血、肺部感染、支气管胸膜瘘和急性呼吸窘迫综合征。在随访期间，189例患者复发，其中51例局部复发，138例远处复发。中位生存时间为24.4个月，总的1年、3年和5年生存率分别为82.7%、50.9%和32.5%。非小细胞肺癌（NSCLC）患者的1年、3年和5年生存率分别为84.1%、52.1%和32.5%，小细胞肺癌（SCLC）患者的1年、3年和5年生存率分别为56.1%、38.5%和28.8%。在NSCLC中，腺癌的预后比鳞癌差。与右肺切除术相比，左肺切除术患者的预后更好。多因素分析显示，ICU住院时间、疾病分期、淋巴结分期和辅助化疗均是影响总生存率的重要因素。结论：肺癌切除术仍是治疗晚期肺癌的一种有效方法。当患者的疾病分期较高、腺癌和右侧肺癌时，外科医生应更加谨慎。新辅助化疗不影响预后。肺切除术也可以在精心挑选的SCLC患者中实现可接受的生存结局。
Introduction: To investigate postoperative complications and the prognostic risk factors of patients underwent pneumonectomy. Methods: Four hundred and six patients underwent pneumonectomy were subjected to the study. All the clinicopathologic data including age, gender, smoking history, surgical treatment, postoperative complications, tumor staging and the follow-up information were investigated. Results: The 30-day and 90-day mortality rates were 3.2% and 6.2%, respectively. Postoperative complications developed in 149 patients (36.7%), mainly included arrhythmia, transfusion, pulmonary infection, bronchopleural fistula and acute respiratory distress syndrome. During the follow-up, 189 patients experienced a relapse, consisting of 51 patients with local recurrence and 138 with distant recurrence. The median survival time was 24.4 months and the overall 1-year, 3-year and 5-year survival rates were 82.7%, 50.9% and 32.5%, respectively. Moreover, the overall 1-year, 3-year, 5-year survival rates for patients with non-small cell lung cancer (NSCLC) were 84.1%, 52.1% and 32.5%, respectively and patients with small cell lung cancer (SCLC) were 56.1%, 38.5% and 28.8%, respectively. Among NSCLCs, adenocarcinomas had a worse prognosis than squamous carcinomas. Compared to right pneumonectomy, patients with left pneumonectomy had a better prognosis. Multivariable analysis revealed ICU stay, disease stage, nodal stage and adjuvant chemotherapy were all significant predictors of overall survival (OS). Conclusions: Pneumonectomy is still a valuable and effective treatment option for patients with advanced lung cancer. Surgeons should be more cautious when patients had higher disease stage, adenocarcinoma and right-side lung cancer. Neoadjuvant chemotherapy did not affect the prognosis. Pneumonectomy could also achieve acceptable survival outcomes in well-selected SCLC patients.
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影响因子：
3.4
作者：
Riquet, Marc;Mordant, Pierre;Le Pimpec-Barthes, Francoise
通讯作者：
Le Pimpec-Barthes, Francoise
影响因子：
2.9
作者：
Kawano D;Okamoto T;Fujishita T;Suzuki Y;Kitahara H;Shimamatsu S;Maehara Y
通讯作者：
Maehara Y
DOI：
10.1016/j.jtcvs.2014.09.063
发表时间：
2015-01-01
影响因子：
6
作者：
Thomas, Pascal A.;Berbis, Julie;Loundou, Anderson
通讯作者：
Loundou, Anderson
影响因子：
2.5
作者：
Ichiki, Yoshinobu;Nagashima, Akira;Yasuda, Manabu
通讯作者：
Yasuda, Manabu
影响因子：
3.6
作者：
Stish, Bradley J.;Hallemeier, Christopher L.;Garces, Yolanda I.
通讯作者：
Garces, Yolanda I.