与I期肺腺癌复发相关的高风险特征
Cameron N Fick1, Elizabeth G Dunne1, Stijn Vanstraelen1
1Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
The Journal of thoracic and cardiovascular surgery
|May 24, 2024
概括
预后特征可以识别患有I期肺腺癌 (LUAD) 的患者在手术后复发的高风险. 这些发现有助于评估早期肺癌患者的预后.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 切除后第一阶段肺腺癌 (LUAD) 的预后因素尚未确定.
- 准确的预后对于管理早期的LUAD至关重要.
研究的目的:
- 为了确定与完全切除后I期LUAD患者复发相关的临床病理特征.
- 为早期的LUAD提供风险分层和治疗决策的信息.
主要方法:
- 对1912名患有病态I阶段LUAD并经过R0切除的患者 (2010-2020年) 的回顾性分析.
- 排除以前患有肺癌,新辅助/辅助疗法,非侵入性/性亚型或过早死亡的患者.
- 用于评估特征和复发之间的关联的Fine和Grey竞争风险回归.
主要成果:
- 5年的累计复发发病率为12%.
- 复发的独立预测因素包括较高的瘤SUVmax,亚叶切除,较高的IASLC等级,淋巴血管入侵,内脏膜入侵和较大的瘤大小.
- 具有3-4个高风险特征的患者的5年复发发病率 (30%) 与没有 (4%) 的患者相比显著更高.
结论:
- 复发是I阶段LUAD切除后患者的一个小组的一个重大问题.
- 确定的临床病理特征有效地识别高风险个体.
- 这些特征应纳入第一阶段LUAD的预后评估.
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