临床N分期分类 III-N2 阶段NSCLC患者接受三模式治疗:一个好的开始是战斗的一半
Junghee Lee1, Yun Soo Hong2, Jin Lee3
1Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
The Annals of thoracic surgery
|March 23, 2025
概括
在第三阶段非小细胞肺癌 (NSCLC) 中分类N2节点参与至关重要. 与cN2a相比,cN2b分类表明,在接受三种疗法治疗的患者中,复发和死亡风险更高.
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:
- 阶段III-N2非小细胞肺癌 (NSCLC) 需要精确的节点分期,以进行最佳的治疗计划.
- 对N2结节参与的分类可能会改进NSCLC患者的预后评估.
研究的目的:
- 评估临床N描述子分类 (cN2a与cN2b) 的预后价值,在接受三模式治疗的III-N2期NSCLC患者中.
- 要确定这个分类是否能预测无复发生存率和总生存率.
主要方法:
- 来自机构注册表的899名连续III-N2期NSCLC患者的分析 (2003-2019).
- 患者接受了新辅助性并发化疗和放射治疗,随后进行手术.
- 临床N2根据成像和组织病理学被分为cN2a和cN2b;使用竞争风险和Cox比例危险模型比较生存结果.
主要成果:
- 56.0%的患者被归类为cN2a,44.0%被归类为cN2b.
- 与cN2a相比,cN2b组的复发 (1.22) 和死亡率 (1.43) 的调整后危险比率明显高于cN2a组.
- 这种增加的风险在腺癌和状细胞癌亚型中都被观察到.
结论:
- 拟议的临床N分类 (cN2a与cN2b) 是第三阶段N2NSCLC预后的一个有价值的预测指标.
- cN2b分类与更高的复发风险和死亡率有关.
- 这种分层有助于决定NSCLC的三模式治疗.
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