| Shuo Li,Yanlin Feng,Chunzi Liang,Jiancheng Tu. Prognostic factors for pN2 non-small cell lung cancer: a comprehensive evidence from 73 studies involving 23,772 patients*. Oncol Transl Med, 2020, 6: 57-63. |
| pN2型非小细胞肺癌预后因素的综合分析：73个研究共23772个样本 |
| Prognostic factors for pN2 non-small cell lung cancer: a comprehensive evidence from 73 studies involving 23,772 patients* |
| Received:January 16, 2020 Revised:May 13, 2020 |
| DOI：10.1007/s10330-020-0403-3 |
| 中文关键词: 非小细胞肺癌；meta分析；预后因素；生存分析 |
| 英文关键词: non-small cell lung cancer; meta-analysis; prognostic factors; overall survival |
| 基金项目:中国国家基础研究973计划（2012CB720605）；武汉大学中南医院科研种子培养计划(znpy2016046) |
| Author Name | Affiliation | E-mail | | Shuo Li | Department &Program of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University | iamshuo@whu.edu.cn | | Yanlin Feng | Department &Program of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University | | | Chunzi Liang | Department &Program of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University | | | Jiancheng Tu* | Department &Program of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University | jianchengtu@whu.edu.cn |
|
| Hits: 9077 |
| Download times: 10062 |
| 中文摘要: |
| 非小细胞肺癌（NSCLC）是常见的恶性肿瘤。pN2型非小细胞肺癌在解剖学、生物学和病患特征上都被认为是异质性非常显著的一种肺癌亚型，且具有病理上同侧纵隔/软骨下淋巴结节转移的特点。在pN2亚型组中，目前还没有根据患者的特征性来确定的预后因素或相关治疗指南。在很多研究某些特定因素在pN2型非小细胞肺癌的预后意义的报告中，特别是手术是否影响其跨过N2转移期的问题上，存在明显的分歧和矛盾。于是，我们对已发表的文献进行了全面的汇总分析，以得出更精确结论。经过全面的文献检索，按照标准共纳入了73项研究，共23773名受试者。结果大多数调查因素，例如高龄、男性、病理性T晚期、临床N晚期、多站N2、扩大手术切除（肺切除术）和不完全切除等获得预期结果，预后较差，但术后治疗（例如化疗和放疗）有利生存。然而我们发现在可手术的pN2型非小细胞肺癌患者中，跳过N2转移是有利的预后因素。就总生存率而言，其他因素（组织学类型和原发肿瘤侧）是中性的。我们重点介绍了pN2型非小细胞肺癌患者的诸多重要预后因素。特别是患有N2跳跃转移的患者，手术反映良好。此发现可辅助临床决策且对后续研究提供支持。 |
| 英文摘要: |
| Obojective Non-small-cell lung cancer (NSCLC) is a common malignancy. pN2 NSCLC, with pathologically
confirmed ipsilateral mediastinal/subcarinal nodes metastasis, has been known as a very heterogeneous
subgroup in terms of its anatomical, biological and patient characteristics. Prognostic factors based on
patient characteristics were not well determined yet in this subgroup, and there is currently no standard
treatment recommendation for these heterogeneous pN2 subjects. Apparent disagreements and
inconsistency exist in study reports concerning the prognostic significance of certain factors in pN2 NSCLC,
especially regarding to the issue about whether skip N2 metastasis benefit from surgery.
Methods We therefore performed this comprehensive summary of the published literatures to draw a
more precise and less uncertain conclusion. After a comprehensive literature search, a total of 73 studies
involving 23,773 subjects were included according to eligibility criteria.
Results As expected, most of the investigated factors, such as old age, male, advanced pathological
T stage, advanced clinical N stage, multiple N2 stations, extended surgical resection (pneumonectomy),
and incomplete resection, but not post-operation treatment (eg. chemotherapy and radiotherapy) were
significantly associated with poor survival. However, skip N2 metastasis was favourable prognostic factors
in operable pN2 NSCLC subjects. Other factors (histological type and primary tumour side) were neutral in
terms of association with overall survival. We highlighted a number of important prognostic factors for pN2
NSCLC patients. Particularly, patients with skip N2 disease benefit from surgery.
Conclusion Our findings could be used as reference information for decision-making in clinical practice
and future study design.n. |
|
View Full Text
Download reader HTML全文 |
| Close |
|
|
|