The Survival And Prognosis In Patients With N₁ Stage Non-small Cell Lung Cancer After Surgery

Objective To analysis the survival and prognosis of N₁ stage in non-small cell lung cancer after radical surgery, in order to provide reference to the choise of operative approach. Methods The clinicopathologic and follow-up data of 430 patients suffering from N1 non-small cell lung cancer who underwent surgery from January 1981 to December 2002 in Tianjin cancer hospital were studied retrospectively. Possible factors were collected in the data of these patients. The factors included sex, age, smoking, smoking indexing, period of disease, the location and the TNM staging of the tumor, the histologic grading of the tumor, exfoliative cytological examination of sputum, tracheoscope pathologic examination, lymphatic metastasis, length of tumor, preoperative and postoperative radio-therapy, preoperative and postoperative chemo-therapy, status of residues, postoperative complications, and so on. All dates were analysised using the statistics software of SPSS11.0. The monovariate analysis was studied to find the possible factors influencing the prognosis, then the multivariate analysis was used to determine the main prognostic factors. Factors related to the prognosis were analyzed by the method of Cox Regression Analysis and their "life curves" were drawn. Results The monovariate analysis showed that patien age, the max diameter of the tumorous, positive status of lower residues, pathobiological type, postoperative chemo-therapy, TNM staging of tumor, lymphatic metastasis, number of metastasic lymphanodes, total numbers of resected lymphanodes, degree of lymphatic metastasis influenced the prognosis; occording to multivariate analysis, total numbers of resected lymphanodes, TNM staging of tumor, postoperative chemo-therapy and, pathobiological type were of prognostic significance; sex, smoking, smoking indexing, preoperative chemo-therapy, postoperative cadio-therapy, postoperative immunotherapy, modus operandi, location of the tumorous, exfoliative cytological examination of sputum, tracheoscope pathologic examination did not influence the survival rate of N₁ non-small cell lung cancer. Conclusion for the patiens of N₁ stage non-small cell lung cancer, total numbers of resected lymphanodes, TNM staging of tumor, postoperative chemo-therapy and, pathobiological type were of prognostic significance. We should aggregate analysis the patien's score of performance status, indexing of weight lose, cardiorespiratory function, location and invade degree of the tumor, status of lymphatic metastasis, and relationgship with vicinity organ. on these grounds, selecting perfect modus operandi. After surgery, we should re-analysis the patien's pathobiological type, postoperative TNM, lymphatic metastasis, number of metastasic lymphanodes, and total numbers of resected lymphanodes, to formulate reasonable individualized treatment plan. Usually, we apply four to six times postoperative chemo-therapy, using two drugs plan containing platinum, our researching prove that postoperative influence patient life span.