Comparative analysis of prognosis between surgical or non surgical treatment for non small cell lung cancer with great vessel invasion in chest / 肿瘤

ABSTRACT

Objective: To compare the prognosis induced by conventional surgery and chemotherapy and radiotherapy for non-small cell lung cancer (NSCLC) with great vessel invasion in chest. Methods: Clinical data from 102 NSCLC patients with great vessel invasion in chest, treated from 2000 to 2002 in our hospital, were reviewed retrospectively. There were 55 patients who received surgical resection and 47 patients who received chemotherapy and radiotherapy. The multiple factors affecting the survival rate and prognosis of patients were analyzed and compared. Results: The median survival time (MST) was 13 months and the 1-, 3-, and 5-year survival rate was 58.18%, 10.91%, and 3.9% for 55 patients who received surgical treatment. The MST was 16 months and the 1-, 3-, and 5-year survival rate was 65.96%, 22.46%, and 4.29%, respectively, for 47 patients who received non surgical management. There was no significant difference in survival rate between surgical and non surgical management (P > 0.05). Univariate analysis showed that clinical staging, PS score, chemotherapy, and radiotherapy were related with prognosis. The multivariate analysis demonstrated that clinical staging, chemotherapy, and radiotherapy served as independent survival factors (P < 0.05). Conclusions: There was no statistical difference in the survival rate of NSCLC patients at T4 stage with heart and great vessel invasion who received conventional surgery and chemotherapy and radiotherapy. Correct patient selection and skilled surgical technique assured complete tumor resection and increased the survival rate. Adjuvant chemotherapy or radiotherapy helped to prolong the post-operative survival time of patients.