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Chest：肺叶切除术的时机对临床ⅠA期肺鳞状细胞癌生存率的影响

2017-08-14 xiangting MedSci原创

肺鳞状细胞癌肺叶切除术时机生存率
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早期肺SCC诊断与手术的间隔时间较长，生存率越低。

由于肺癌诊断后手术时间与生存率之间的关系尚未得到精确描述，因此不存在临床有意义的早期肺癌切除延迟的指南。这项研究检验了延长IA期鳞状细胞癌（SCC）诊断和肺叶切除术之间的时间与生存率更差相关的假说。

使用多变量Cox比例风险分析和限制三次样条（RCS）函数评估了在国家癌症数据库（2006-2011）临床ⅠA期SCC患者肺叶切除术时间与生存率的关系。

符合入选标准的4,984例患者的5年总体生存率为58.3％（95％CI：56.3％-60.2％）。1811例（36％）患者在诊断的30天内进行了手术，而到手术的中位时间为38天（IQR为23-58）。在多变量分析中，诊断后38天或以上手术的患者比早期手术患者的5年存活率显著降低（危险比（HR），1.13（95％CI：1.02-1.25）; p = 0.02）。多变量RCS分析显示切除拖延的时间越长，与手术时间相关的HR呈稳定增加；与显著更差的生存率相关的阈值时间为90天或更长。

早期肺SCC诊断与手术的间隔时间较长，生存率越低。虽然除治疗时间以外的其他因素也会导致这一发现，但这些结果表明尽量减少手术前拖延可以提高生存率。

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    2018-05-28 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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    2018-03-14 qingting

    #细胞癌#

    0

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    2018-05-23 zsyan

    #肺鳞状细胞癌#

    0

  4. 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encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 00:49:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929398, encodeId=1ced1929398f9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Sep 22 12:49:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1876927, encodeId=623018e69271e, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-17 xiangyuzhou971

    #EST#

    0

  5. 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channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat Jun 23 21:49:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256589, encodeId=72b51256589bf, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556433, encodeId=184f155643321, content=<a href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-09-22 Smile2680

    #Chest#

    0

  6. 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encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 00:49:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929398, encodeId=1ced1929398f9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Sep 22 12:49:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1876927, encodeId=623018e69271e, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat Jun 23 21:49:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256589, encodeId=72b51256589bf, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556433, encodeId=184f155643321, content=<a href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2018-06-23 doctorzheng

    #切除术#

    0

  7. 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encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 00:49:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929398, encodeId=1ced1929398f9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Sep 22 12:49:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1876927, encodeId=623018e69271e, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, 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href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-16 guoyibin

    #生存率#

    0

  8. 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href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-16 zhangj7113

    #肺叶切除#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=319383, encodeId=a01e319383eb, content=学习了.谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Mon May 28 12:22:51 CST 2018, time=2018-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978535, encodeId=5aad19e853589, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, 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channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat Jun 23 21:49:00 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256589, encodeId=72b51256589bf, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556433, encodeId=184f155643321, content=<a href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-14 天涯183

    非常好的文章，学习了，很受益

    0

  10. 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href='/topic/show?id=a9b0820898c' target=_blank style='color:#2F92EE;'>#肺叶切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82089, encryptionId=a9b0820898c, topicName=肺叶切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=727d14772225, createdName=zhangj7113, createdTime=Wed Aug 16 02:49:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233480, encodeId=74f1233480a0, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Mon Aug 14 13:30:00 CST 2017, time=2017-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233474, encodeId=43cc2334e46e, content=好好学习努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon Aug 14 12:56:19 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-14 忠诚向上

    好好学习努力

    0

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