基于SEER数据库的肿瘤直径大于7.0厘米的非小细胞肺癌患者预后分析

冯婷婷; 陈众众; 闫文锦; 王玉秀; 张峻; 徐兴祥; 陈勇; 杨俊俊; 闵凌峰

doi:10.3971/j.issn.1000-8578.2021.19.1587

基于SEER数据库的肿瘤直径大于7.0厘米的非小细胞肺癌患者预后分析

Prognosis Analysis of Non-small Cell Lung Cancer with Diameter over 7.0 cm Based on SEER Database

摘要

摘要:
目的区分肿瘤直径 > 7.0 cm的非小细胞肺癌（NSCLC）患者死亡风险，评估手术及非手术治疗的临床价值。
方法基于SEER数据库收集2010—2015年肿瘤直径 > 7.0 cm非小细胞肺癌患者数据。寿命表法计算1、2、3年生存率，Kaplan-Meier法绘制生存曲线，单因素及多因素Cox回归模型分析预后影响因素。
结果纳入的5 519例患者1、2、3年累计生存率分别为51.8%、33.0%、25.0%。单因素、多因素Cox回归分析显示肿瘤大小、淋巴结N分期、治疗方式是影响NSCLC的预后独立危险因素（P < 0.001）。
结论 N0~N1期肿瘤直径 > 7.0 cm非小细胞肺癌患者，手术治疗有利于患者生存预后。N2期肿瘤直径7.0~9.0 cm组，手术治疗在改善患者预后方面存在优势。N2期肿瘤直径≥9.0 cm组以及N3期患者手术与非手术患者预后方面差异未见统计学意义。姑息治疗不能改善患者预后。

Abstract:
Objective To analyze the mortality risk and evaluate the curative effects of surgery and non-surgery on NSCLC with diameter > 7.0 cm.
Methods We collected the data of NSCLC patients with diameter > 7.0 cm from 2010 to 2015 from the SEER database. The 1, 2, 3-year survival rates were analyzed by life table method. Overall survival curve was estimated by Kaplan-Meier method. Univariate and multivariate Cox regression models were used to analyze the independent prognostic factors.
Results The 1, 2, 3-year survival rates were 51.8%, 33.0% and 25.0%, respectively. In univariate and multivariate analyses, tumor size, N stage and treatment were the independent prognostic factors (P < 0.001).
Conclusion Surgery is benefited for the prognosis of stage N0-N1 NSCLC patients with diameter > 7.0 cm. And for stage N2 NSCLC patients with diameter 7.0-9.0 cm, surgical treatment has advantages in improving the prognosis. Surgical and non-surgical patients with tumor diameter ≥9.0 cm or lymph node N3 stage have no statistically significant differences in prognosis. In addition, palliative treatment does not improve the prognosis of patients.

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