94例肺癌合并其他原发恶性肿瘤生存分析

Multiple primary malignancies involving lung cancer: A survival analysis of 94 cases

  • 摘要: 目的 探讨影响肺癌合并其他原发恶性肿瘤预后的因素,为多原发肿瘤的防治提供依据。 方法 回顾性分析本院2005年1月- 2015年5月肺癌合并其他原发恶性肿瘤患者的病历资料,分析性别、吸烟史、肿瘤家族史、肺癌临床分期、肺癌发生的顺序、多原发肿瘤发生的时间间隔及肺癌的治疗方式等对此类患者预后的影响。 结果 截至2015年10月,共随访94例患者,失访2例,失访率2.1%。94例中,先发肺癌30例,先发其他肿瘤64例,肺癌先发者的生存率低于其他肿瘤先发者(中位生存时间39个月vs 97个月,P< 0.001)。同时性肿瘤22例,异时性肿瘤72例,中位生存时间分别为23个月和96个月,异时性多原发肿瘤者生存率较高(P< 0.001)。Cox回归分析显示,肺癌的临床分期、发生顺序、治疗方式及多原发肿瘤发生的时间间隔是肺癌合并其他原发肿瘤患者预后的独立影响因素。 结论 晚期肺癌、肺癌先发、同时性多原发肿瘤患者预后较差,手术切除肺部病灶有利于患者的预后。

     

    Abstract: Objective To explore the prognostic factors of patients with multiple primary malignancies (MPM) involving lung cancer, and try to find some clues for prevention and clinical treatment of these patients. Methods Clinical data about 94 hospitalized patients with multiple primary malignancies involving lung cancer in Chinese PLA General Hospital from January 2005 to May 2015 were reviewed. Follow-up was done in those patients. The prognostic factors were analyzed including gender, smoking history, family history, tumor stage of lung cancer, order of occurrence, time inteval of occurrence of multiple primary malignancies and treatment of lung cancer. Results A total of 94 cases were enrolled in this study and 2 patients were (2.1%) lost to follow-up until October 2015. Of the 94 patients, 30 had lung cancer diagnosed first (LCF) and 64 had other cancers diagnosed first (OCF). OCF patients showed significantly better overall survival (OS) than LCF patients (median OS, 39 months vs 97 months, P< 0.001). Twenty-two cases had synchronous multiple primary malignancies (SMPM) and 72 had metachronous multiple primary malignancies (MMPM), with a median OS of 23 and 96 months, respectively. MMPM patients demonstrated significantly better OS than SMPM patients (P< 0.001). COX regression analysis indicated that stage of lung cancer, order of occurrence, lung cancer treatment and time inteval of occurrence of multiple primary malignancies were independent prognostic factors of patients with multiple primary malignancies involving lung cancer. Conclusion Advanced lung cancer stage, lung cancer diagnosed first and synchronous multiple primary malignancies are significantly associated with poor OS among the patients with multiple primary malignancies involving lung cancer. Surgical resection for lung cancer is the independent predictive factor for longer survival time.

     

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