摘要
目的探究不同随访方式对Ⅰ~ⅢA期非小细胞肺癌(non-small cell lung cancer,NSCLC)术后患者5年生存率的影响。方法回顾性收集2014年7月至2020年7月9家医院经病理确诊为Ⅰ~ⅢA期NSCLC行手术治疗11958例患者的临床资料,男6939、女5019例,平均年龄(59.8±9.5)岁。按随访方式将患者分为主动随访组(3825例)和被动随访组(8133例),并在确诊后半年内开始随访的患者。使用Kaplan-Meier生存曲线和Cox比例风险模型进行分析。结果主动随访组和被动随访组中位随访次数分别为8.0次和7.0次;单次随访时间分别为3.77 min和3.58 min;5年生存率分别为81.8%和74.2%(HR=0.60,95%CI 0.53~0.67,P<0.001)。多因素分析表明随访方式、年龄、性别、手术方式等因素均影响预后,并且在不同分期的亚组多因素分析中呈现一致的结果。结论Ⅰ~ⅢA期NSCLC患者术后主动参与随访可以提高远期生存率,并且ⅢA期患者的生存获益更为明显。
Objective To compare the 5-year survival rates between two different follow-up patterns of postoperative stageⅠ-ⅢA non-small cell lung cancer(NSCLC)patients.Methods Pathological stageⅠ-ⅢA NSCLC 11958 patients who underwent surgical resection and received follow-up within 6 months after initial diagnosis through telephone follow-up system were included in nine hospitals from July 2014 to July 2020.The patients were divided into two groups including a proactive follow-up group(n=3825)and a passive follow-up group(n=8133)according to the way of following-up.There were 6939 males and 5019 females aged 59.8±9.5 years.The Kaplan-Meier and Cox proportional hazards regression model were used.Results The median follow-up frequency was 8.0 times in the proactive follow-up group and 7.0 times in the passive follow-up group.The median call duration was 3.77 minutes in the proactive follow-up group and 3.58 minutes in the passive follow-up group.The 5-year survival rate was 81.8%and 74.2%(HR=0.60,95 CI0.53-0.67,P<0.001)in the proactive follow-up group and the passive follow-up group,respectively.Multivariate analysis showed that follow-up pattern,age,gender and operation mode were independent prognostic factors,and the results were consistent in all subgroups stratified by clinical stages.Conclusion The proactive follow-up leads to better overall survival for resected stageⅠ-ⅢA NSCLC patients,especially in the stageⅢA.
作者
孙大强
陈平雁
刘伦旭
李小飞
胡坚
许林
付向宁
刘阳
刘德若
张逊
何建行
SUN Daqiang;CHEN Pingyan;LIU Lunxu;LI Xiaofei;HU Jian;XU Lin;FU Xiangning;LIU Yang;LIU Deruo;ZHANG Xun;HE Jianxing(Department of Thoracic Surgery of Tianjin Chest Hospital,Tianjin,300051,P.R.China;Hainan Institute of Real World Data,Department of Biostatistics,Southern Medical University,Guangzhou,510515,P.R.China;Department of Thoracic Surgery of West China Hospital,Sichuan University,Chengdu,610041,P.R China;Department of Thoracic Surgery of Tangdu Hospital,Fourh Military Medical Universiy,Xi'an,710038,P.R.China;Department of Thoracic Surgery of The First Hospital Afiliated to Medical Cllege of Zhejiang University,Hangzhou,310009,P.R.China;Department of Thoracic Surgery of Jiangstu Key Laboratory of Molecular and Translational Cancer Research,Cancer Institute of Jiangsu Province,Nanjing.210009,P.R.China;Department of Thoracic Surgery of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430010,P.R.China;Department of Thoracic Surgery of Chinese People's Liberation Army General Hospital,Beijing,100038,P.R China;Department of Thoracic Surgery of China Japan Friendship Hospital,Bejing,100029,P.R.Chind;Department of Thoracic Surgery of The First Afiliated Hospital of Guangzhou Medical University,Guangzhou,510120,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第6期615-622,共8页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
非小细胞肺癌
手术
随访方式
5年生存率
真实世界研究
Non-small cell lung cancer
surgical resection
follow-up pattern
5-year survival rate
real-world study
