在接受切除的IIIB/N2阶段非小细胞肺癌患者的新辅助治疗后进行手术
Mithat Fazlıoglu1, Volkan Erdogu2, Necati Citak3
1Department of Thoracic Surgery, Tekirdag Namik Kemal University Medical Faculty, Tekirdag, 59030, Turkey. mfazlioglu@nku.edu.tr.
BMC pulmonary medicine
|July 19, 2025
概括
手术可能有利于选定的非小细胞肺癌 (NSCLC) 患者的IIIB/N2阶段疾病,特别是在新辅助疗法后. 然而,瘤入侵和并发症会影响存活率,这凸显了肺癌治疗中需要仔细选择患者的必要性.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 癌症研究 癌症研究
背景情况:
- 晚期非小细胞肺癌 (NSCLC) 的分期往往排除了手术干预.
- 多模式治疗方法对于管理局部晚期NSCLC至关重要.
- 在IIIB/N2期NSCLC中手术的作用仍然是研究的主题.
研究的目的:
- 评估手术切除在经过精心挑选的患有IIIB/N2期NSCLC的患者中的疗效.
- 评估中体下降阶段,局部瘤入侵和术后并发症对生存结果的影响.
- 为了确定影响该患者队列生存的预后因素.
主要方法:
- 对1752名经过手术的NSCLC患者 (2010-2016) 的回顾性分析.
- 确定了49名临床IIIB/N2期NSCLC患者,符合特定标准 (单站,非体积大的N2,可切除).
- 使用卡普兰-梅尔和考克斯回归的生存分析,分层按T阶段和中间体下降阶段分层.
主要成果:
- 总体5年生存率 (OS) 为29.2% (中位数为23个月);5年无病生存率 (DFS) 为22.0% (中位数为12.4个月).
- 中下降与改善的生存状况相关 (p=0.049).
- 局部瘤入侵 (HR: 2.15, p=0.045) 和术后并发症 (HR: 2.93, p=0.011) 是更糟糕的OS的独立预测因素.
结论:
- 手术切除可能是高度选择的cIIIB/N2 NSCLC患者的可行选择,特别是那些对新辅助疗法和解剖切除能力有良好的反应的患者.
- 瘤入侵和术后并发症显著损害了生存结果.
- 精确的患者选择和优化的术后管理对于改善这种NSCLC亚组的存活率至关重要.
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