手术治疗的非小细胞肺癌手术时间和COVID-19流行病的临床意义
Áron Ghimessy1,2,3, János Fillinger3, Márton Csaba1
1Department of Thoracic Surgery, National Institute of Oncology, Budapest, Hungary.
Thoracic cancer
|September 11, 2025
概括
对非小细胞肺癌 (NSCLC) 的手术延迟显著恶化了患者的生存率. 虽然COVID-19大流行普遍增加了手术等待时间,但特定的感染波并没有进一步影响延迟.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 流行病学 流行病学
背景情况:
- 及时诊断和治疗对于非小细胞肺癌 (NSCLC) 的生存至关重要,因为长期的结果主要是在早期疾病中实现的.
- 了解影响手术延迟的因素对于优化NSCLC患者管理至关重要.
研究的目的:
- 调查手术时间对接受治疗意图切除的NSCLC患者的整体生存时间的影响.
- 评估COVID-19大流行对NSCLC诊断和手术之间的时间的影响.
主要方法:
- 对2536名经过肺切除的高加索NSCLC患者进行了回顾性分析.
- 卡普兰-梅尔生存分析和日志等级测试被用于基于手术截止时间 (1个月,2个月,77天,91天) 的生存结果进行比较.
- 采用多变量考克斯回归建模,确定整体生存的独立预测因素,包括手术时间,年龄,糖尿病,疾病阶段和血管侵袭.
主要成果:
- 术前2个月或更长的时间与整体存活率受损 (p=0.002) 有显著关联.
- 在多变量模型中,术前的时间,年龄,糖尿病,疾病阶段和血管侵袭都被确定为整体生存的独立预测因素.
- 在COVID-19大流行期间,诊断到手术的中位时间比大流行前期显著增加了12天 (p<0.001).
结论:
- 手术前的时间是手术治疗NSCLC患者长期生存的独立预后因素.
- 由于COVID-19大流行,NSCLC患者的手术干预发生了显著的延迟.
- 关于特定的主要COVID-19感染波,没有观察到对手术时间的显著影响.
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