Analysis Of Prognosis Factors Of ?A(N2) Non-small Cell Lung Cancer After Complete Resection

Objective:Research the factors associated with metastasis, recurrence and survival of ?A N2non-small-cell lung cancer(NSCLC) patients with postoperative, provide objective basis for postoperative patients with choice radiotherapy.Methods:Collect the medical and follow-up data of Shanxi Province tumor hospital between January 2009 and December 2013 postoperative stage for ?A N2 NSCLC patients of complete surgical resection. Factors associated metastasis and recurrence of after complete resection ?A N2 NSCLC patients was analyzed by single factor analysis with X2 text. Factors associated metastasis and recurrence was analyzed by multiple factors analysis with COX regression model. Clear about the independent risk factors for metastasis and recurrence. Independent risk factors associated with recurrence compared survival rate by long-rank test. Drawing survival curve with Kaplan-Meier. There are obvious difference for statistical significance.Results:1.Collected 199 cases of after complete resection of staging for ?A N2 NSCLC patients with complete follow-up data of 173 cases. The median follow-up time were26.8 months. 1,2 years distant metastasis rates were 38.7%,52.6%.1,2 years recurrence rates were 27.8%,39.1%.1,2 years survival rates were 92.5%,51.4%.2.Single factor analysis of distant metastasis found that gender,pathological types,operative method,the number of positive lymph nodes,lymph node metastasis rate,preoperative CEA,one positive of preoperative CEA/CY211/SCC and two positive of preoperative CEA/CY211/SCC were associated with after complete resection ?A N2 NSCLC patients with distant metastasis(P < 0.05).Multiple factors analysis found that only pathological types(P=0.013 95%CI:1.237-6.182) and two positive of preoperative CEA/CY211/SCC(P=0.014 95%CI:0.687-2.065) were the independent risk factors for distant metastasis.3. Single factor analysis of recurrence found that pathological types,the number of positive lymph nodes,lymph node metastasis area number,subcarinal lymph node metastasis, lymph node metastasis rate, one positive of preoperative CEA/CY211/SCC and two positive of preoperative CEA/CY211/SCC were associated with the patients with recurrence(P < 0.05).Multiple factors analysis found that the number of positive lymph nodes( P=0.046 95%CI; 1.009-3.062),lymph node metastasis area number(P=0.004 95%CI:1.337-4.712), lymph node metastasis rate(P=0.028 95%CI:1.101-5.436)and two positive of preoperative CEA/CY211/SCC(P=0.001 95%CI:0.876-3.027)were the independent risk factors for recurrence.4.Compared survival rate with the independent risk factors for metastasis and recurrence found that pathological types hasn't statistically significant difference(P >0.05), the number of positive lymph nodes,lymph node metastasis area number, lymph node metastasis rate and two positive of preoperative CEA/CY211/SCC have statistically significant difference(P<0.05).Survival rate decline of the patients with the number of positive lymph nodes more than 4,multiple regional lymph node metastasis, lymph node metastasis rate greater than or equal to 20%.Conclusions:Two positive of preoperative CEA/CY211/SCC is the independent risk factor for after complete resection ? A N2 NSCLC patients with distant metastasis and recurrence.The number of positive lymph nodes,lymph node metastasis station number and lymph node metastasis rate are the independent risk factors for recurrence.Two positive of preoperative CEA/CY211/SCC,the number of positive lymph nodes,lymph node metastasis station number and lymph node metastasis rate are the risk factors for survival.The part of the patients may benefit from adjuvant radiotherapy,then improve the local control rate and extend the total survival time.