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目的探究高龄早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者不同手术方式对预后的影响。方法回顾性分析2012年1月至2013年12月延安大学附属医院胸外科100例70岁以上Ⅰ期非小细胞肺癌患者的临床资料,男60例、女40例,年龄70~85(76±12)岁。其中62例行标准肺叶切除和系统淋巴结清扫术为全肺叶切除组,38例患者行亚肺叶切除和系统性淋巴结清扫术为肺叶部分切除组。术后随访患者,分析患者术后并发症发生情况及影响预后的因素。结果全肺切除组和肺叶部分切除组的并发症发生率分别为35.5%(22/62)和39.5%(15/38),3年、5年总生存率分别为85.5%、54.8%和78.9%、55.3%,两组差异无统计学意义(P>0.05)。病情分期是影响患者预后的独立因素。结论高龄Ⅰ期非小细胞肺癌患者进行肺叶全切除和肺叶部分切除均可取,二者具有相似的预后。
Objective To explore the effects of different surgical methods on the prognosis of patients with early-stage non-small cell lung cancer (NSCLC). Methods The clinical data of 100 patients with stage I and above of stage I non-small cell lung cancer were retrospectively analyzed from January 2012 to December 2013 in thoracic surgery of Affiliated Hospital of Yan’an University. There were 60 males and 40 females, aged 70-85 (76±). 12) years old. Sixty-two patients underwent standard lobectomy and systematic lymph node dissection for the whole lobectomy group, and 38 patients underwent sub-lobar resection and systemic lymph node dissection for the partial lobar resection group. Patients were followed up after surgery to analyze the postoperative complications and factors that affected the prognosis. Results The complication rates of pneumonectomy and partial lobar resection were 35.5% (22/62) and 39.5% (15/38), respectively. The 3-year and 5-year overall survival rates were 85.5%, 54.8%, and 78.9 respectively. %, 55.3%, there was no significant difference between the two groups (P> 0.05). Stage of disease is an independent factor that affects the prognosis of patients. Conclusions The total lobar resection and partial lobar resection can be performed in elderly patients with stage I non-small cell lung cancer, and both have similar prognosis.