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Background and purpose: Adenocarcinoma has become the most common histological type of lung cancer in recent years, and there is an increasing trend. This study aimed to investigate postoperative differences in clinical characteristics between adenocarcinoma and other types of non-small cell lung cancer (NSCLC) and prognostic factors of adenocarcinoma treated with surgery, and to provide a reference for the prevention and treatment of lung adenocarcinoma. Methods: The medical records of patients with NSCLC treated with surgery were selected from Jan. 2005 to Dec. 2014 at the Affiliated Tumor Hospital of Guangxi Medical University. This study compared the differences in clinical characteristics between adenocarcinoma and other types of NSCLC, and analyzed the influence of prognostic factors of lung adenocarcinoma with log-rank test and COX model. Results: With 451 cases of adenocarcinoma, the gender ratio was 1.29:1, the average age was 56.02 years old, the lymph node metastasis rate was 53.22% (240/451), and the median survival time was 44 months. There were statistical differences between adenocarcinoma and other types of NSCLC in gender ratio (P<0.001), average age (P=0.039), lymph node metastasis rate (P=0.012), and median survival time (P<0.001). In multivariate analysis, PTNM stage (P<0.001), gender (P=0.032), preoperative diabetes (P=0.019), subcarinal lymph node metastasis (P=0.013), number of lymph node metastasis (P<0.001), postoperative chemotherapy (P=0.040) or targeted therapy after surgery (P<0.001) were independent prognostic factors. Conclusion:Compared with other types of NSCLC, adenocarcinoma showed the characteristics of higher incidence of constituent ratio in women, lower average age, higher rate of lymph node metastasis and poor prognosis. PTNM stage, gender, pre-operative diabetes, subcarinal lymph node metastasis, number of lymph node metastasis, postoperative chemotherapy or targeted therapy are important influencing factors that can affect the prognosis of adenocarcinoma following the surgical procedure.
ABSTRACT
Objective To provide the reference basis for reducing the occurrence of nutritional risk by analyzing possible risk factors for nutritional risk status and investigating the relationship between preoperative nutritional risk status and prognosis.Methods We retrospectively analyzed the clinical data of 894 patients(nutritional risk group of 491 cases,non-nutritional risk group of 403 cases) with esophageal cancer resection.The univariate analysis was used to analyze the relationships between nutritional risk status with postoperative complications and length of hospitalization.And the multiple Logistic regression model analysis was applied to analyze the risk factors of nutritional risk status.Results The nutritional risk group had a higher rate of postoperative complications (33.60 ％ vs.19.60 ％,U =-3.429,P =0.001),higher incidence of serious complications (23.01％ vs.8.68％,U =-3.611,P =0.000) and longer hospital stays [(37.20 ± 13.89) days vs.(31.69 ± 13.49) days,t =4.124,P =0.000] than that of non-nutritional risk group.The results of the multiple logistic regression analysis showed that the preoperative nutritional risk factors were associated with the patients' age (OR =1.58,95％ CI:1.101-2.268),number of symptoms entries(OR =7.97,95 ％ CI:6.071-10.463),symptom severity (OR =0.26,95％ CI:0.186 -0.385),and dietary intake (OR =0.62,95 ％ CI:0.482-0.813),P ＜ 0.05 for all.Conclusion The older patients with more severe symptoms and poor diet are more likely to suffer from nutritional risk.Prolonged hospital stay and postoperative complications easily happen in patients with nutritional risk.So patients with preoperative nutritional risk should be given timely and effective nutrition intervention measures,in order to reduce postoperative complications and length of hospitalization.