肺癌根治术后局部复发的多因素分析

目的回顾性分析118例肺癌根治术后患者的局部复发预后因素,探讨肺癌术后辅助放疗的指征。方法收集2007年6月～2009年6月共118例肺癌根治术后患者,记录其相关的临床病理因素及局部复发情况,用Kaplan-Meier法计算无复发生存率,用Log-rank法和Cox模型分别进行单因素和多因素预后分析,分析影响局部复发的预后因素。结果随访率100%。随访时间为随访6～55个月,中位数27个月。1年、2年、3年无复发生存率分别为73.1%、61.8%、56.3%,中位复发时间为10个月。单因素分析结果显示术前CEA升高、术前贫血、肿瘤大小、T分期、N分期等为影响局部复发的因素,多因素分析结果显示术前CEA升高、T分期、N分期等为影响局部复发的独立预后因素。结论术前CEA水平、T分期以及N分期是肺癌根治术后局部复发的独立预后因素,对于此类患者,局部复发风险高,可能需要更进一步的治疗,如辅助放疗等。

Risk factors for local relapse in postoperative patients with lung cancer

Objective To analyze the risk factors for local relapse in postoperative patients with lung cancer,and then to explore a subgroup of patients that could benefit from adjuvant radiotherapy. Methods From June 2007 to June 2009,118 eligible patients were enrolled,local relapse free survival analysis were performed by the Kaplan-Meier method. Univariate and multivariate analyses were performed by the Log-rank method and Cox regression analyses,respectively. Results The follow-up rate was 100%. The median follow-up time was 27 months（range from 6 months to 55 months）. Local relapse free survival rates at 1 year,2 years and 3 years were 73A%, 61.8% and 56.3% ,respectively. The median relapse time was 10 months. Univariate analyses showed that CEA level, hemoglobin level, tumor size, T stage and N stage were sig- nificantly associated with local relapse, and multivariate analyses showed that CEA level, T stage and N stage were the in- dependent risk factors for local relapse. Conclusion CEA level,T stage and N stage were the independent factors for local relapse in postoperative patients with lung cancer, patients with these risk factors might benefit from further local treat- ment, such as radiotherapy.