| 摘要 |
Objective: Resection is the best treatment for patients with Stage I non-small cell
lung cancer (NSCLC). Distant metastasis is the most frequent cause of treatment
failure and cause of death in NSCLC. The goal of this study was to evaluate the
clinicopathologic characteristics, pattern of distant failure, disease-free time and
survival in patients with resected Stage I NSCLC.
Methods: We retrospectively reviewed the clinicopathologic characteristics of 155
patients of resected Stage I NSCLC with distant failure in Taipei Veterans General
Hospital between 1980 and 2000. Disease-free time, survival, and their predictors
were analyzed.
Results: Patients were followed up for 20.5 months (mean, 25.4 19.5 months).
Distant failure occurred at 11.5 months (median, 95% CI: 9.8 to 13.6 months). The
disease-free rate and survival at 2 and 5 years were 12.9% and 1.3%, and, 43.2% and
6.5%, respectively. The sites of distant failure were bone in 52 (33.5%), lung to lung
in 39 (25.2%), brain in 37 (23.9%) and liver in 17 (11.0%). A second site of distant
failure was noted in 35 of 155 patients (22.6%): bone in 13 (37.1%) and lung to lung
in 8 (22.9%). Multivariate analysis showed that tumor size and histological type had
significant impact on disease-free survival (P=0.003, 0.003), and tumor size,
histological type and first site of distant failure had significant impact on overall
survival (P=0.034, <0.001, 0.009). Patients with squamous cell carcinoma survived
shorter than patients with adenocarcinoma (hazard ratio 1.90, 95% CI: 1.29~2.79).
Patients with the first distant failure site being brain and bone had significantly worse
survival than those with lung to lung distant failure (hazard ratio: 2.04 and 1.80, 95%
CI: 1.25-3.35, and 1.16-2.77).
Conclusions: The survival was poor for patients of resected Stage I non-small cell
lung cancer after distant failure. Tumor size is the significant predictor for both disease-free and overall survival. |
