中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2015年
10期
604-608
,共5页
梁朝阳%强光亮%张真榕%马千里%田燕雏%宋之乙%石彬%郭永庆%刘德若
樑朝暘%彊光亮%張真榕%馬韆裏%田燕雛%宋之乙%石彬%郭永慶%劉德若
량조양%강광량%장진용%마천리%전연추%송지을%석빈%곽영경%류덕약
胸外科手术,电视辅助%肺肿瘤%腺癌%肺段切除术%肺叶切除术
胸外科手術,電視輔助%肺腫瘤%腺癌%肺段切除術%肺葉切除術
흉외과수술,전시보조%폐종류%선암%폐단절제술%폐협절제술
Thoracic surgery%video-assisted Lung neoplasms Adenocarcinoma Segmentectomy Lobectomy
目的 评价胸腔镜(VATS)肺段切除与肺叶切除手术治疗病理Ⅰ期肺腺癌的远期肿瘤学疗效.方法 回顾性分析2004年6月至2014年6月期间接受VATS治疗的519例Ⅰ期肺腺癌患者的临床资料,其中接受肺段切除术者91例,肺叶切除术者428例,对两组患者使用倾向评分匹配,比较两组临床病理特征与远期生存.结果 两组在肿瘤大小(P ＜0.001)及脉管浸润状态(P =0.049)方面的差异有统计学意义.两组患者5年无复发生存率和总生存差异无统计学意义.多因素Cox回归分析显示年龄和脉管浸润状态是独立的预后因素,而术式、性别、吸烟史与肿瘤长径不是独立的预后因素.两组患者匹配91对,变量包括年龄、性别、吸烟史、肿瘤大小、肿瘤位置及脉管浸润状态在两组间分布均衡.VATS肺段切除组与肺叶切除组5年无复发生存率(77.1％对79.3％,P=0.802)和总生存比例(85.3％对81.0％,P=0.333)差异无统计学意义.结论 胸腔镜肺段切除术治疗病理Ⅰ期肺腺癌可达到与肺叶切除术相同的远期疗效.
目的 評價胸腔鏡(VATS)肺段切除與肺葉切除手術治療病理Ⅰ期肺腺癌的遠期腫瘤學療效.方法 迴顧性分析2004年6月至2014年6月期間接受VATS治療的519例Ⅰ期肺腺癌患者的臨床資料,其中接受肺段切除術者91例,肺葉切除術者428例,對兩組患者使用傾嚮評分匹配,比較兩組臨床病理特徵與遠期生存.結果 兩組在腫瘤大小(P ＜0.001)及脈管浸潤狀態(P =0.049)方麵的差異有統計學意義.兩組患者5年無複髮生存率和總生存差異無統計學意義.多因素Cox迴歸分析顯示年齡和脈管浸潤狀態是獨立的預後因素,而術式、性彆、吸煙史與腫瘤長徑不是獨立的預後因素.兩組患者匹配91對,變量包括年齡、性彆、吸煙史、腫瘤大小、腫瘤位置及脈管浸潤狀態在兩組間分佈均衡.VATS肺段切除組與肺葉切除組5年無複髮生存率(77.1％對79.3％,P=0.802)和總生存比例(85.3％對81.0％,P=0.333)差異無統計學意義.結論 胸腔鏡肺段切除術治療病理Ⅰ期肺腺癌可達到與肺葉切除術相同的遠期療效.
목적 평개흉강경(VATS)폐단절제여폐협절제수술치료병리Ⅰ기폐선암적원기종류학료효.방법 회고성분석2004년6월지2014년6월기간접수VATS치료적519례Ⅰ기폐선암환자적림상자료,기중접수폐단절제술자91례,폐협절제술자428례,대량조환자사용경향평분필배,비교량조림상병리특정여원기생존.결과 량조재종류대소(P ＜0.001)급맥관침윤상태(P =0.049)방면적차이유통계학의의.량조환자5년무복발생존솔화총생존차이무통계학의의.다인소Cox회귀분석현시년령화맥관침윤상태시독립적예후인소,이술식、성별、흡연사여종류장경불시독립적예후인소.량조환자필배91대,변량포괄년령、성별、흡연사、종류대소、종류위치급맥관침윤상태재량조간분포균형.VATS폐단절제조여폐협절제조5년무복발생존솔(77.1％대79.3％,P=0.802)화총생존비례(85.3％대81.0％,P=0.333)차이무통계학의의.결론 흉강경폐단절제술치료병리Ⅰ기폐선암가체도여폐협절제술상동적원기료효.
Objective To compare long-term oncologic outcomes between segmentectomy and lobectomy by video-assisted thoracic surgery(VATS) for pathological stage Ⅰ lung adenocarcinomas.Methods Retrospective research was conducted on patients underwent VATS segmentectomy or lobectomy for pathological stage Ⅰ lung adenocarcinoma at China-Japan Friendship Hospital between June 2004 and June 2014.VATS segmentectomy was performed on 91 patients and VATS lobectomy on 428 patients.We compared the characteristics and long-term survival between the two groups and in propensity score-matched pairs.Results Significant differences were observed between groups with regard to tumor size(P ＜ 0.001) and lymphovascu lar invasion status (P =0.049).No significant difference was observed in 5-year disease-free survival (DFS) or overall survival (OS).Multivariate Cox regression analyses revealed age and lymphovascular invasion significant independent prognostic factors, whereas procedure(segmentectomy vs.lobectomy), gender, smoking history and tumor size were not.In 91 propensity score-matched pairs with variables adjusted for age, gender, smoking history, tumor size, tumor location, and lymphovascular invasion, the 5-year DFS(77.1％ vs.79.3％) and OS(85.3％ vs.81.0％) after VATS segmentectomy and lobectomy re mained comparable(P =0.802 and P =0.333, respectively).Conclusion VATS segrnentectomy achieved similar long-term survival outcomes as those who underwent VATS lobectomy for pathological stage Ⅰ lung adenocarcinoma.
