Multimodality therapy including surgical resection for limited small cell lung cancer.

From 1975 through 1990, 199 patients with limited small cell lung cancer (LSCLC) were subjected to multimodality treatment including surgical resection combined with chemotherapy or chemoradiotherapy in our department. The median postoperative survival time of the 199 patients was 39 months, and the 5-year survival rate was 26%, which was decreased with increase of tumor-stage. In comparison of the survival time of patients in Stage Ⅰ and those in Stage Ⅲa, there was a significant difference (P<0.01). There were no significant differences in survival rate of 3 and 5 years between the patients receiving chemotherapy prior to or after surgical resection. The improvement in survival was documented by surgical resection combined with chemotherapy or chemoradiotherapy for LSCLC. The effect of multimodality treatment is correlated with tumor P-TNM staging, the involvement of lymph node, especially that of the mediastinal lymph node, is a negative factor influencing the prognosis. Surgical resection as an ini     

Surgical management for carcinoma of the gallbladder: a single-institution experience in 25 years

Background Gallbladder carcinoma is rare and associated with dismal outcomes. Radical surgery is the only curative treatment, and options for adjuvant therapy remain limited. This study aimed to determine the factors influencing outcome of treatment in patients with gallbladder carcinoma, and to identify the patients who might benefit from radical surgery and adjuvant therapy. Methods Medical records and follow-up histories of 150 patients with gallbladder carcinoma who had undergone surgery between April 1980 and December 2005 were retrospectively reviewed. The factors predictive for the survival of the patients were identified using multivariate analysis. Results Surgery for gallbladder cancer was associated with an overall 5-year survival rate of 26.2%. After curative resection （40% of the patients）, the 5-year survival rate was 60.3%. The patients who underwent R0 resection had a significantly longer median survival （97.3 months） than those who had R1/R2 resection （8.3 months） or only laparotomy （3.7 months） （P 〈0.0001）. Univariate analysis showed that resectability, American Joint Committee on Cancer staging, tumor grade, adjuvant therapy, jaundice at presentation, depth of tumor invasion, lymph node involvement, distant metastasis, and carcinoembryonic antigen level were statistically significant predictors for survival. Multivariate analysis revealed American Joint Committee on Cancer staging and resectability were independent prognostic factors for survival. The patients who underwent noncurative resection might benefit from adjuvant therapy （median survival, 12.4 months vs 7.2 months, P=-0.006）. Conclusions Favorable survival rate can be achieved after curative resection, even for selected patients with advanced disease. Adjuvant therapy may improve the survival of patients with gallbladder carcinoma.     

Long-term outcome and prognostic factors of intrahepatic cholangiocarcinoma

Background The management of intrahepatic cholangiocarcinoma （ICC） remains a challenge due to poor prognosis. The aim of this study was to summarize the surgical management experience in recent 10 years and to identify the influencing factors related to outcome of patients with ICC in a single hepatobiliary center. Methods From January 1995 to June 2005, 136 patients with ICC undergoing surgery were reviewed retrospectively. Survival rates of patients were calculated using the Kaplan-Meier method and compared by using the log-rank test. The prognostic factors were identified by the Cox regression model. Results Seventy-nine of 136 patients underwent resection, and 65 of 79 patients were curative （R0）. The surgical mortality was 2.2%. The 1-, 3- and 5-year survival rates of patients undergoing R0 resection were 72.1%, 35.6% and 20.1% respectively, which were significantly longer than those who underwent palliative resection and exploration, respectively （P 〈0.01）. At stage IV of the disease, 10 patients who underwent aggressive curative resection achieved a better median survival than those （n=12） without resection （14 months vs 3 months, P 〈0.001）. The independent prognostic factors of the whole group were TNM stage （OR, 2.013, P=0.008） and curative resection （OR, 2.957, P=0.003）. Higher TNM stage （OR, 1.894, P=0.004） and lymph node metastasis （OR, 4.248, P=0.005） linked to poor prognosis after R0 resection. For patients without lymph node metastasis, the median survival of those who underwent regional lymphadenectomy was comparable with those who did not （18 months vs 22 months, P=0.817）. Conclusions R0 resection is mandatory for ICC patient to achieve long-term survival. Aggressive resection benefits for selected patients with local advanced disease. Higher TNM stage and lymph node metastasis were poor prognostic factors for ICC patients after R0 resection.     

A Prospective Study on Therapeutic Gain by Concurrent Chemoradiotherapy for Stage Ⅱ-Ⅳa Nasopharyngeal Carcinoma

The benefit achieved by concurrent chemoradiotherapy(CCR) and sequential chemoradiotherapy(SCR) vs radiotherapy(RT) alone for patients with stage Ⅱ-Ⅳa nasopharyngeal carcinoma(NPC) was compared.A total of 113 patients with stage Ⅱ-Ⅳa NPC were allotted into CCR group(n=38),SCR group(n=36) and RT alone group(n=39).All patients were irradiated with the same RT technique to ≥66 Gy at 2 Gy per fraction,conventional 5 fractions/week in all groups.The CCR group received concurrent chemotherapy of weekly cisplatin for 7 weeks,and the SCR group received neoadjuvant and(or) adjuvant chemotherapy.The results showed that the 3-and 5-year overall survival rate was significantly higher in CCR group than in RT alone group(92.16% vs 61.54%,81.58% vs 51.28%,P<0.005).The median survival time was significantly longer in CCR group than in RT alone group(67.8 months vs 52.7 months,P<0.005).It was concluded that CCR could significantly improve overall survival rate,progression-free survival rate,and median survival time when compared with RT alone.     

Application of ultrasound-guided percutaneous radiofrequency ablation in treatment of liver cancer.

Objective To investigate the therapeutic efficacy and its influencing factors of ultrasoundguided percutaneous radiofrequency ablation (PRFA) in the treatment of liver carcinoma. Methods With a temperature-controlled multi-electrode needle, ultrasound-guided PRFA was employed to treat forty-seven patients with 67 tumor nodules, with a diameterof 2.6 ± 1.1 cm (1.0 - 5.5 cm). Results A complete ablation (CA) rate of 80. 6% was achieved in the present series, with a CA rate of 91.7 % in the tumors ≤3 cm in diameter,75. 0% in tumors from 3.1 to 4. 0 cm,and 14. 3% in tumors >4 cm. The CA rate was significantly greater in tumors with a temperature rising up to 70℃ within the initial 2 minutes at ablation as compared with that longer than 2 minutes (P < 0.05). A markedly higher CA rate was obtained in tumors with an ablation-maintaining temperature of over 80℃ than that between 70℃ and 80℃ ( P < 0. 01). All patients were followed up with a mean time of 11. 3 months. The local recurrence rate was 9.3% (5/     

Clinicopathological Characteristics and Prognosis of Patients with Adenosquamous Lung Carcinoma

This study was aimed to characterize clinicopathological features and prognosis of patients with adenosquamous lung carcinoma(ASC). Among the 2531 patients with lung cancer who underwent surgery between January 2000 and June 2012 in our hospital, 59 were histologically diagnosed as having ASC. The clinicopathological features and follow-up data of ASC patients were collected and analyzed statistically. Superior lobectomy was accomplished in 40 patients, middle and inferior lobectomy in 3, lobectomy plus partial resection of contralateral lung in 5, partial lung resection in 4, and pneumonectomy in 7. Moreover, 22 cases were found to be adenocarcinoma-predominant, and 18 to be squamous cell carcinoma-predominant. The median survival time was 13.6 months, and the 1-, 3-, and 5-year survival rates were 59.9%, 36.4% and 31.2%, respectively. Of the 52 cases with tissue specimens available, 11 had an EGFR mutation(21.2%) and 2 had a KRAS mutation(3.8%). Multivariate analysis showed that histology subtype, pleural invasion, TNM stage, and postoperative treatment were all independent prognostic factors. The data from the current study demonstrated that SCC-predominant histology represents a better prognosis of ASC. Histology subtype, pleural invasion, TNM stage, and postoperative treatment are independent prognostic factors for ASC and adjuvant therapy may help control the disease.     

SEVEN CASES OF EPITHELIAL OVARIAN CARCINOMA WITH BRAIN METASTASIS

Objective To summarize the clinical characteristics, treatment, and prognosis of brain metastasis in patients with epithelial ovarian carcinoma. Metbods Retrospective analysis was conducted in 7 cases of brain metastases of epithelial ovarian carcinoma from January 1986 to March 2007 in Peking Union Medical College Hospital for summarizing therapy results and prognosisaffecting factors. Results Incidence of brain metastases of epithelial ovarian carcinoma was about 0. 66% （7/1 055 ）. Serous adenocarcinoma was the predominant pathological type in 4 cases and the subsequent was adenocarcinoma in 3 cases. All the patients were diagnosed at late stage, 6 cases with the International Federation of Gynecology and Obstetrics （HGO） stage Ⅲc and 1 with FIGO stage IV. The mean duration from diagnosis of ovarian carcinoma to brain metastasis was 32.7 ± 20. 0 months （range, 23-73 months）. Single metastasis focus occurred in 43% of cases and multiple metastases in 57% of cases. Fifty-seven percent of patients presented extracranial metastasis. Serum CA125 played a role in monitoring reoccur- rence and brain metastases. The average survival time was about 12 months. Better treatment with prolonged survival could be achieved by combination of operation and chemotherapy or combination of radiotherapy with chemotherapy. Concltusions As a rare condition, brain metastasis of epithelial ovarian carcinoma is rising in incidence with improved treatment of ovarian carcinoma and prolonged survival. However, brain metastasis indicates bad prognosis which can be improved by combined therapy.     

Clinical and pathological features and surgical treatment of Budd-Chiari syndrome-associated hepatocellular carcinoma

Background Budd-Chiari syndrome （BCS） is characterized by liver sinusoidal congestion,ischemic liver cell damage,and liver portal hypertension caused by hepatic venous outflow constriction.The aim of this research was to investigate the clinicopathological features of BCS-associated hepatocellular carcinoma （HCC） and explore its surgical treatment and prognosis.Methods Clinical data from 38 patients with BCS-associated HCC who were surgically treated in our hospital from July 1998 to August 2010 were retrospectively analyzed.The clinicopathological features and prognosis of patients with BCS-associated HCC and surgical treatment for BCS-associated HCC were investigated.Results Compared to the patients with hepatitis B virus （HBV）-associated HCC,the patients with BCS-associated HCC showed a female predominance,and had significantly higher cirrhosis rate,higher incidence of solitary tumors,lower incidence of infiltrative growth,higher proportion of marginal or exogenous growth,lower rate of portal vein invasion,and higher degree of differentiation.Median survival was longer in patients with BCS-associated HCC （76 months） than in those with HBV associated HCC （38 months）.Of 38 patients with BCS-associated HCC,22 patients who received combined surgery mainly by liver resection plus cavoatrial shunts exhibited hepatic venous outflow constriction relief,while the other 16 patients only underwent liver resection.The combined surgery group had significantly longer survival and lower incidences of post-operative lethal complications （P 〈0.05）.Multivariate analysis showed that relief of hepatic venous outflow obstruction was a protective factor for survival of patients with BCS-associated HCC,whereas portal vein invasion was a risk factor.Conclusions BCS-associated HCC has a more favorable biological behavior and prognosis than HBV-associated HCC.For patients with BCS-associated HCC,tumor resection accompanied with relief of hepatic venous outflow obstruction can reduce the incidence of complications and extend survival.     

THE EVALUATION OF THE LONG-TERM RESULTS IN THE TREATMENT OF SALIVARY GLAND CARCINOMA

This paper summarized the long-term follow-up results and our clinical treatment experience of 426 patients with carcinoma of salivary gland, who had undergone surgical treatment in our department from 1957 to 1976 successively. Our study showed that the 10-year and 15-year survival rates were 63.3% and 59.1% respectively, much higher than the results presented by other researchers. The following four points were concluded: 1. The long-term treatment result of salivary gland carcinoma is determined not only on mode of treatment and clinical stage, but more on its pathologic type. For high malignant salivary carcinoma, comprehensive multidiscipline treatments should be adopted. 2. Management of primary focus." The different operative principle and mode shouht be worked out in advance according to pathologic type and primary site of tumors. 3. Management of lymphonode: For cases with undifferentiated carcinoma, low-differentiated mucoepiderrnoid carcinoma, squamous cell carcinoma, adenocarcinoma and papillary cystadenocarcinoma, elective neck dissection should be performed. 4. Prevention of distant metastasis: Preoperative biopsy should be avoided. Frozen-section should be made during the operation and, diagnosis and treatment be accomplished in the meantime.     

Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine

Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.     

病理Ⅰ期非小细胞肺癌的诊断与外科治疗

目的探讨工期非小细胞肺癌（NSCLC）患者的诊断与治疗。方法回顾性分析我院1991年至2004年226例Ⅰ期NSCLC的诊疗经过。全组肺叶切除206例，肺段或楔形切除15例，袖状切除5例。结果无围手术期死亡，Ⅰ期NSCLC患者的1、3、5年生存率分别为93．6％、80．3％和66．2％。鳞癌的1、3、5年生存率均比腺癌与腺鳞癌患者的1、3、5年生存率高（P〈0．05）。肺叶切除患者的1、3、5年生存率比肺段或楔形切除患者高（P〈0．05）。结论定期体检及综合检查对Ⅰ期肺癌的早期发现与诊断极为重要。外科治疗可以获得很好的疗效，肺叶切除加纵隔淋巴结清扫是早期肺癌的有较好预后的治疗方案。     

手术治疗肺肉瘤样癌22例预后影响因素分析

目的：探讨手术治疗肺肉瘤样癌（LSC）后长期生存率及预后影响因素.方法：对22例LSC均行根治性手术治疗,其中肺叶切除18例,全肺切除3例,肺叶切除合并心包部分切除1例.术后评价可能的预后因素对长期生存的影响.结果：术后1、3、5现年总生存率分别为63.6%、18.2%和4.5%;单因素分析显示,p-TNM分期和N分期均是影响患者术后长期生存的主要因素（P〈0.05）;多因素分析显示,年龄、p-TNM分期和病理分化程度均是影响预后的独立危险因素（P〈0.01）.结论：LSC治疗效果不佳,手术后5年生存率极低.年龄、p-TNM分期和病理分化程度均是影响LSC手术预后的主要因素.     

Ⅲa期非小细胞肺癌综合治疗的临床分析

目的 探讨非小细胞肺癌综合治疗的标准及疗效。方法 对1991年至1999年底手术切除的812例Ⅲa期非小细胞肺癌（NSCLC）的治疗结果进行分析。同时,将全组中326例综合治疗与486例单纯手术病例进行对比。结果 全组5年生存率16．4％,其中综合治疗组23．5％,单纯手术组10．2％。综合治疗组5年生存率中鳞癌占27．6％,腺癌23．4％;单纯手术组5年生存率中鳞癌占15．2％,腺癌9．9％。结果显示：综合治疗组生存率高于单纯手术组。结论 多学科综合治疗应成为中、晚期NSCLC的标准治疗方式．并且根据不同TNM、病理类型选择不同治疗组合。     

非小细胞肺癌并发孤立性肾上腺转移患者手术疗效的系统回顾及pooled分析

目的：对非小细胞肺癌(NSCLC)并发孤立性肾上腺转移患者的手术疗效进行系统回顾及pooled分析,为手术治疗NSCLC并发孤立性肾上腺转移提供依据。方法：检索1990年1月-2013年1月发表在PubMed和ScienceDirect数据库中与NSCLC并发孤立性肾上腺转移手术治疗相关的回顾性研究文献,并进行pooled分析。结果：纳入符合筛选标准的文献11篇,含87例患者,均行肺叶或全肺切除术和肾上腺手术治疗,术后患者平均生存期为41个月（95%CI,30.6~51.3个月）;中位生存期为16个月（95%CI,9~23个月）,1、2和5年生存率分别为64.0%、37.7%和29.2%。单因素预后分析,异时性肾上腺转移(MAM)患者预后明显优于同时性转移(SAM)者,2组患者1、2和5年生存率分别为80.5%和46.8%、52.3%和22.%及35.0%和22.5%,中位生存期分别为31个月和 12个月;而不同病理类型的原发性肺癌（鳞癌和腺癌）、纵隔淋巴结转移与否和肾上腺转移灶位置（与原发灶同侧或对侧）等因素与患者预后无关联。结论：部分NSCLC并发孤立性肾上腺转移患者经肺部手术及肾上腺切除术治疗后可以获得长期生存,而且MAM患者预后好于SAM患者。     

伴有同肺叶内转移的N0-1M0非小细胞肺癌的预后分析

目的 分析同肺叶内转移的N0-1M0非小细胞肺癌的预后,探讨将叶内转移的非小细胞肺癌的T4分期进行下调的合理性.方法 通过回顾性分析,评估2001年1月至2007年9月中山大学肿瘤防治中心胸外科收治的手术治疗的同肺叶内转移的非小细胞肺癌患者的临床资料.入组患者的术后病理分期为N0-1M0期,评价这些患者的预后情况.统计分析用SPSS 10.0完成,生存分析用Kaplan-Meier法.结果 共有46例患者符合入组条件,纳入生存分析.总的5年生存率为29.2%,中位生存期为53.0个月.腺鳞癌的中位生存期为24个月,而其他病理类型的中位生存期为48个月,差异有统计学意义(P=0.003).全肺切除者中位生存期为24个月,非全肺切除者中位生存期为60个月,差异有统计学意义(P=0.023).结论 将伴有同肺叶内转移的非小细胞肺癌的T4分期进行下调是合理的;同肺叶内转移的N0-1M0的非小细胞肺癌是有手术指征的,但全肺切除需要慎重考虑.腺鳞癌患者的预后较差,但需要更大样本的研究来证实.     

纵隔原发性软组织肉瘤22例诊治分析

目的 总结纵隔原发性软组织肉瘤的临床表现、影像特征及预后影响因素.方法 回顾性分析中国医学科学院肿瘤医院1978年1月到2005年7月收治的22例纵隔原发性软组织肉瘤的临床资料,包括临床表现、术前诊断、影像学特点、免疫组织化学特点、治疗方式和生存时间.结果 22例患者中位年龄46岁;胸痛、呼吸困难、咳嗽和肩痛是最常见的临床表现;影像学上多表现为巨大的分叶状肿物;全组5年生存率62.8%,肿瘤大小(肿瘤≥10 cm者5年生存率38.8%,肿瘤＜10 cm者5年生存率65.6%;P=0.019)影响预后,手术方式(完全性切除者中位生存期84个月,不完全切除者中位生存期8个月;P=0.059)影响预后的趋势明显.而组织学分级(高分级者5年生存率38.2%,低分级者5年生存率60%;P=0.317)、分期(Ⅰ期5年生存率60%,Ⅲ期5年生存率38.2%;P=0.317)和综合治疗(单纯手术者中位生存期8个月,综合治疗者中位生存期12个月;P=0.204)对预后影响不明显.结论 手术性质及肿瘤大小是影响纵隔原发性软组织肉瘤的重要预后因素.     

The surgical treatment of lung cancer: a retrospective analysis of 2004 cases

Objective　To summarise the clinical results of surgical treatment of 2004 cases of lung cancer over a period of 33 years and to evaluate the main influencing factors for long-term results. Methods　2004 patients treated at our department were included in this study. The pathological classification proposed and revised by WHO in 1982 was used. The TNM (tumour, nodes, and metastasis classification) system of staging proposed and modified by UICC (International Union Against Cancer) in 1987 was followed. Pearson’s Chi-square test was used in comparing variables. Results　There were 1571 men and 433 women, with a man to woman ratio of 3.6∶1. The pathological findings were squamous cell carcinoma (944 cases, 47.1%), adenocarcinoma (694, 34.6%), small cell carcinoma (167, 8.3%), adenosquamous cell carcinoma (78, 3.9%), large cell carcinoma (22, 1.1%), alveolar cell carcinoma (17, 0.8%) and miscellaneous carcinoma (82, 4.1%). The p-TNM staging in 1721 resected cases was: stage 0 (2 cases, 0.1%), stage Ⅰ (860, 50%), stage Ⅱ (407, 23.6%), staging Ⅲa (396, 23.0%), stage Ⅲb (35, 2.0%) and stage Ⅳ (21, 1.2%). The overall resection rate was 85.9% (1721/2004) and the complication rate was 15.7% (271/1721). The 30-day mortality was 1.3% (22/1721). The 5-, 10- and 15-year survival rates were 38.8%, 31.6% and 21.8%, respectively. Factors influencing the long-term survival rate included the nature of resection, the mode of resection, presence or absence of lymph gland metastasis, tumour size and degree of extension, pathological type and p-TNM staging. Conclusions　Surgery is recommended for stage Ⅰ, Ⅱ and Ⅲa non-small cell lung cancer and for stage Ⅰ and Ⅱ small cell lung cancer. Meticulous preoperative staging process is important. Bronchoplastic resection is recommended to replace pneumouectomy whenever the conditions are permissible.     

癌栓分型对肝细胞性肝癌合并门静脉癌栓治疗及预后的指导意义

目的　探讨癌栓分型对肝细胞性肝癌合并门静脉癌栓患者治疗及预后的指导意义。方法　 2 0 0 0年 1月至 2 0 0 3年 1月 ,选择东方肝胆外科医院收治的 84例肝癌伴门静脉癌栓患者 ,根据Ⅰ～Ⅳ癌栓分型标准相应分为Ⅰ～Ⅳ组 ,回顾分析各组患者生存时间及接受手术与非手术治疗后的疗效。结果　Ⅰ组 (1 7例 )、Ⅱ组 (2 6例 )、Ⅲ组 (35例 )、Ⅳ组 (6例 )的中位生存时间分别为 1 0 1个月、7 2个月、5 7个月和 3 0个月 ,各组差异有显著性意义 (P =0 0 0 0 1 )。癌栓Ⅰ型至Ⅲ型 ,手术疗效均优于非手术疗效 (P =0 0 0 0 6 )。结论　癌栓分型有助于肝癌合并门静脉癌栓患者治疗方案的制定并判断预后。     

Adenosquamous cell carcinoma of the cervix--a clinical analysis of 23 cases

From January 1976 through December 1985, 895 patients with cervical carcinoma were treated with radical hysterectomy and pelvic lymphadenectomy. The surgical specimens of 23 cases were proved to be adenosquamous cell carcinoma, the incidence being 2.6%. Among them, 15 were at stage IB, 7 were at stage IIA and one was at stage IIB. The overall 5-year survival rate was 55.0% and there was no difference between patients at stage IB and IIA. During the same period the 5-year survival rate of squamous cell carcinoma was 87.5% for patients at stage IB and 75.0% for patients at stage IIA. Pelvic lymph node metastasis and parametrial involvement are considered to be poor prognostic factors. When metastasis or invasion happens, the metastatic or invasive lesions can be found in the form of pure squamous carcinoma or adenocarcinoma. Postoperative adjuvant radiotherapy (external irradiation plus brachytherapy) seems to be effective in preventing recurrence. Chemotherapy (PVB regimen) needs more clinical evaluation. In this study, when metastasis or recurrence developed, the response to radiotherapy and/or chemotherapy were poor and 75% of patients died within one year.     

肺大细胞神经内分泌癌14例临床分析

目的分析肺大细胞神经内分泌癌(LCNEC)临床相关特点及治疗、预后和影响预后的因素。方法回顾性分析14例手术确诊LCNEC患者的临床相关因素。结果无一例术前确诊;术后病理免疫组化分析符合神经内分泌特点;术后12例行铂类辅助化疗,但8例在手术后数月内发生复发或转移,中位生存期为19个月。1年生存率85.7%(12/14);2年生存率为21.4%(3/14);3年生存率≤14.3%(2/14)。统计分析显示,期别、淋巴结转移和术后是否辅助化疗可能与预后相关。结论LCNEC是一种预后差、易侵袭和转移的肿瘤,不同分期、淋巴结转移程度和辅助化疗可能影响预后。