术后辅助化疗对T2N0期大细胞类肺癌预后的影响

目的:探讨术后辅助化疗对T2N0期行肺癌根治术的大细胞类肺癌患者预后的影响。方法:将美国SEER数据库2004年-2016年间收录的接受肺癌根治术的T2N0期311例病理类型为大细胞癌或大细胞神经内分泌癌的肺癌患者资料纳入研究，其中接受行肺癌根治术联合化疗的有96例（手术+化疗组），仅接受肺癌根治术的有215例（单纯手术组）。分析并比较辅助化疗对T2N0期行肺癌根治术的大细胞类肺癌患者预后的影响，同时采用1∶1倾向性匹配方法分析两组患者预后情况。结果:倾向性匹配前，与单纯手术组相比，手术+化疗组的总预后及肿瘤特异性预后均有明显优势（P＜0.05）；多因素Cox回归分析提示治疗方式是影响本组患者总预后及肿瘤特异性预后的关键因素（P＜0.05），而病理类型对预后的影响较小（P＞0.05）。倾向性匹配后亚组分析发现，手术+化疗组的总预后及肿瘤特异性预后均明显优于单纯手术组（P＜0.05）；多因素Cox回归分析提示，治疗方式和年龄是影响本组患者总预后及肿瘤特异性预后的关键因素（P＜0.05）。结论:辅助化疗能够明显改善T2N0期大细胞类型肺癌患者的预后，值得临床推荐。

The effect of adjuvant chemotherapy on the prognosis of T2N0 stage large cell lung cancer

Objective:To investigate the effect of postoperative adjuvant chemotherapy on the prognosis of patients with T2N0 stage large cell lung cancer undergoing radical surgery.Methods:The data of 311 patients with T2N0 stage large cell lung cancer who underwent radical resection of lung cancer from 2004 to 2016 in SEER database of the United States were included in the study.Among them,96 patients received radical resection of lung cancer combined with chemotherapy (surgery+chemotherapy group),and 215 patients received only radical surgery (operation group).We analyzed and compared the effect of adjuvant chemotherapy on the prognosis of patients with T2N0 stage large cell lung cancer undergoing radical resection.At the same time,the 1∶1 propensity matching method was used to analyze the prognosis of the two groups.Results:Before propensity matching,compared with the simple operation group,the overall prognosis and cancer specific prognosis of the surgery+chemotherapy group were significantly better (P＜0.05).Multivariate Cox regression analysis showed that the treatment mode was the key factor affecting the overall prognosis and cancer specific prognosis of this group of patients (P＜0.05),while the pathological type had little effect on the prognosis (P＞0.05).After propensity matching subgroup analysis,the overall prognosis and cancer specific prognosis of the surgery+chemotherapy group were significantly better than those of the simple surgery group (P＜0.05).Multivariate Cox regression analysis showed that the treatment mode and age were the key factors affecting the overall prognosis and tumor specific prognosis of this group of patients (P＜0.05).Conclusion:Adjuvant chemotherapy can significantly improve the prognosis of patients with T2N0 large cell lung cancer,which is worthy of clinical promotion.