【摘要】 目的探讨70岁以上老年人非小细胞肺癌手术治疗的结果及围手术期并发症对预后的影响。方法回顾性分析宣武医院胸外科自2005年1月至2008年10月,手术治疗的70岁以上老年非小细胞肺癌患者116例,年龄70~82岁,平均74.4岁。随访满5年,生存数据统计到2013年4月,随访率91.4%。结果术后临床病理TNM分期Ⅰ期17例(14.7%):ⅠA期5例,ⅠB期12例。Ⅱ期为42例(36.2%):ⅡA期11例,ⅡB期31例。Ⅲ期57例(49.1%):ⅢA期50例,ⅢB期7例。全肺切除9例(7.8%),肺叶切除97例(83.6%),楔形切除或肺段切除10例(8.4%)。5年生存率Ⅰ期65.3%,Ⅱ期42.6%,Ⅲ期18.7%(P<0.05)。Ⅰ、Ⅱ、Ⅲ期术后患者的无病生存时间分别为(61.7±3.5)个月、(44.8±3.7)个月、(28.9±2.6)个月(F=8.741,P=0.005),总生存期分别为(66.3±2.7)个月、(54.6±1.8)个月、(32.7±2.4)个月(F=4.941,P=0.036)。患者共出现围手术期并发症47例(40.5%),围手术期死亡率为1.7%。术前是否合并心肺血管疾病所导致的患者术后生存期的差异无明显统计学意义。结论对于70岁以上的老年肺癌患者,术前合并心肺血管疾病一般不是手术禁忌。重视术前心肺脑功能评估,选择适当的手术方式,可获得良好的远期生存。更多还原

【Abstract】 Objective To study the prognosis of non small cell lung cancer(NSCLC) in elderly patients after surgery.Methods 116 NSCLC patients of 70 year or older underwent surgery treatment from 2005 to 2008.The data were statistically analyzed by Kaplan-Meier method.Comparison of the differences in survival rates among groups was made according to the Log-Rank test.The follow-up time was more than 5 years and follow-up rate was 91.4%.Results Of 116 cases,17(14.7%) patients were in stageⅠ,42(36.2%) were in stageⅡ,57(49.1%) were in stageⅢ.Surgery procedure include pneumonectomy for 9 patients(7.8%),lobectomy for 97 patients(83.6%),segementectomy and wedge resection for 10 patients(8.4%).The five year survival rate for stage Ⅰ,Ⅱ,Ⅲ were 65.3%,42.6%,18.7%,respectively(P < 0.05).The DFS of postoperative patients with Ⅰ,Ⅱ,Ⅲ were(61.7 ± 3.5) months,(44.8 ± 3.7) month,(28.9 ± 2.6) month(F = 8.741,P = 0.005).The OS of postoperative patients withⅠ,Ⅱ,Ⅲwere(66.3 ± 2.7) months,(54.6 ± 1.8) months,(32.7 ± 2.4) months(F = 4.941,P = 0.036).47 patients(40.5%) had severe complications.The perioperative mortality was 1.7%.Conclusion Elderly patients with NSCLC should undergo surgical therapy.Preoperative period combined lung or cardiovascular disease is not surgery contraindications.Operative indications and proper pattern of surgery were necessary for doctors to obtain good therapeutic results and long-term prognosis in elderly patients.更多还原