Survival Analysis Of The Solid-dominant Tumor Of CT1-nsclc:(RUL)SⅠ、SⅡ And SⅢ

Objective: In recent years,the results show that the lymphatic drainage patterns of different segments of the right upper lobe are different,and it is not clear whether there is a difference in survival between the right upper lobe(right upper lobe,RUL)and between SⅠ,SⅡ and SⅢ.The purpose of this study is to explore whether there are survival differences between the above segments and analyze the reasons。Methods: During the period from January 1,2012 to January 1,2017,right upper lobectomy by VATS was performed in the fourth Hospital of Hebei Medical University.The staging was c T1,solid/tumor ratio(consolidation/tumor ratio,C/T)≥ 0.5,the postoperative pathology was non-small cell lung cancer(non-small cell lung cancer,NSCLC).Kaplan-Meier method was used to draw the survival curve,Log-rank logarithmic test was used to compare,Cox regression model was used to analyze the factors affecting survival,and the relapse-free survival rate(disease-free survival,DFS)and overall survival rate(overall survival,OS)were compared among the groups.Results: 99 patients met the inclusion criteria,including 20 cases of apical segment(SⅠ),49 cases of posterior segment(S Ⅱ)and 30 cases of anterior segment(S Ⅲ).There was no significant difference between the 5-year OS rate(SⅠ: 94.7%,SⅡ: 88%,SⅢ: 80.4%,P = 0.547)and DFS rate(SⅠ: 89.5%,SⅡ: 89.3%,SⅢ: 85.9%,P = 0.952).Sex(HR = 9.476,95% CI: 1.212-74.064,P = 0.032)、smoking(HR = 7.132,95% CI: 1.538-33.076,P = 0.012),tumor size(≤ 1 cm versus ≤ 2 cm: HR = 0.125,95% CI: 0.018-0.888,P = 0.038;≤ 2 cm versus ≤ 3 cm: HR = 0.125,95% CI: 0.017-0.840,P = 0.032),squamous cell carcinoma(versus Adenocarcinoma: HR = 9.840,95% CI: 2.449-38.355,P = 0.001)is a prognostic factor,there was no significant difference between lymph node metastasis(P > 0.05)and pleural invasion(P > 0.05).The rate of lymph node metastasis was the highest in the 4 groups(12.5%),and there was no lymph node metastasis in the lower mediastinum in each group.Conclusions: There was no significant difference in 5-year OS rate and DFS rate between SⅠ,SⅡ and SⅢ in c T1 stage RUL solid dominant non-small cell lung cancer.Smoking,tumor size and squamous cell carcinoma were prognostic factors,while lymph node metastasis and pleural invasion were not.There was almost no lower mediastinal lymph node metastasis in c T1 stage RUL solid dominant NSCLC.