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JNCI:肺癌复发和死亡评估的临床研究

2015-04-06 丁宁 MedSci原创

背景:对以人口为基础的肺癌复发和复发后死亡率的绝对风险评估,对临床肺癌患者的管理有指导意义。 方法:从2002~2005年,我们评估了伦巴第和意大利普通人群中2098例肺癌患者复发和生存的预后因素,并进行生存分析和分别评估IA~IIIA期手术治疗患者和IIIB~IV期非手术治疗患者的绝对危险因素。 结果:转移的绝对风险拓展到了每一期的局部复发和细胞的类型,这突出了肺癌的全身性威胁。在I期,确诊

背景:对以人口为基础的肺癌复发和复发后死亡率的绝对风险评估,对临床肺癌患者的管理有指导意义。

方法:从2002~2005年,我们评估了伦巴第和意大利普通人群中2098例肺癌患者复发和生存的预后因素,并进行生存分析和分别评估IA~IIIA期手术治疗患者和IIIB~IV期非手术治疗患者的绝对危险因素。

结果:转移的绝对风险拓展到了每一期的局部复发和细胞的类型,这突出了肺癌的全身性威胁。在I期,确诊后一年内的死亡率为2.7%,但是复发后一年内的死亡率为48.3%;在IV期,确诊后和复发后的概率分别为 57.3% 和80.6%,超过一半的患者在转移后的1年内死亡。虽然从IA~IB期,约有1/3的患者复发,但ⅡA期患者复发的风险( 61.2 % )与IIB 期( 57.9 %)和IIIA 期( 62.8 %)患者相似。IA~IIIA期经手术治疗的非小细胞肺癌患者脑转移的风险随肿瘤分级的上升而增加,而鳞癌和腺癌复发的绝对风险几乎相同。

结论:这项基于人群的研究为临床提供了有用的适用于普通人群肺癌复发和死亡的评估,这些数据表明:患者需要更多整体和局部的辅助治疗。风险评估的各个端点对功率取决于事件绝对数量的临床试验设计有重要意义。

原始出处

Consonni D1, Pierobon M1, Gail MH2, Rubagotti M1, Rotunno M1, Goldstein A1, Goldin L1, Lubin J1, Wacholder S1,Caporaso NE1, Bertazzi PA1, Tucker MA1, Pesatori AC1, Landi MT2.Lung cancer prognosis before and after recurrence in a population-based setting.J Natl Cancer Inst.2015 Mar 23

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    2015-05-24 ljjj1053

    不错,学习了

    0

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    2015-04-07 清氺訫

    看看

    0

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    2015-04-07 清氺訫

    0

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    2015-04-07 清氺訫

    0

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    2015-04-07 清氺訫

    值得学习

    0

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