2013~2014年中国非小细胞肺癌手术治疗模式横断面研究

Abstract

目的 了解我国不同中心非小细胞肺癌手术治疗现状,比较患者特征及治疗模式的差异.方法 对数据库中8387例患者数据进行筛选,提取2013~2014年根治性目的手术治疗的Ⅰ~Ⅲ期非小细胞肺癌患者,共纳入14个省市、17家三甲医院的5060例患者.提取患者的一般情况、术前检查、手术治疗模式、术后病理等点位进行分析.结果 患者男3204例,女1856例;年龄(59.7±9.11)岁(19~86岁).术前肺功能检查FEV1(2.23±0.67)L,FEV1/FVC平均81.8%.64.6%的患者术前至少有一种合并疾病.肿瘤直径(3.28±1.94)cm.手术时间(181.1±71.0)min.术后病理方面,59.8%为腺癌,30.2%为鳞癌.男性腺/鳞癌比例1.03:1,女性16.4:1.所有接受肺叶切除手术的患者中,50.1%为微创手术,各中心微创手术比例8.3%~90.2%.各中心肺叶切除术中清扫淋巴结站数中位数5.9(3.0~7.4)站.患者平均住院花费53830.8(42205~100113)元.结论 中国非小细胞肺癌患者特征及手术治疗模式有自己独特的特点,各中心患者术前基线、手术治疗模式及治疗花费差异有统计学意义.

Objective To investigate the current situation of Chinese non-small cell lung cancer( NSCLC) surgical treat-ment in different centers.And to compare the differences of patient characteristics and treatment patterns .Methods Data of 5060 NSCLC patients out of 8387 patients from 14 provinces, 17 third-grade class-A hospitals was obtained .All included pa-tients were stage ⅠtoⅢ, and were treated with curative-intent surgeries during the years of 2013 and 2014.Patient character-istics, preoperative examinations, surgical treatment patterns and pathology et al.were analyzed.Results There were 3204 males and 1856 females.The patients' age was among 19~86(59.7 ±9.11)years old.Mean preoperative FEV1 was(2.23 ± 0.67)L, and mean FEV1/FVC was 81.8%.64.6% patients accompanied with at least one comorbidity.The mean diameter of tumor was(3.28 ±1.94)cm.Duration of surgery was(181.1 ±71.0) minutes.Pathology confirmed 59.8% as adenocarcino-ma, and 30.2% as squamous carcinoma.The ratio of adenocarcinoma/squamous cell carcinoma was 1.03:1 in all male pa-tients.And the ratio is 16.4:1 in female patients.Among all the patients that underwent lobectomies, 50.1% patients under-went micro-invasive surgeries(VATS or mini-incision surgery).The rate of micro-invasive surgery is among 8.3% to 90.2%. The number of lymph nodes stations harvested in lobectomy was 5.9(mean 3.0 -7.4).Mean hospital cost was 53830.8 ( mean 42205-100113 ) yuan.Conclusion The Chinese NSCLC patients who underwent surgeries own unique patient charac-teristics.The baseline characteristics, surgical treatment patterns and hospital cost varied among different centers.