Recurrence and metastasis in patients with non-small cell lung cancer after minimally invasive surgery
10.3969/j.issn.1007-1989.2017.09.008
- VernacularTitle:非小细胞肺癌患者微创切除术后的复发与转移状况研究
- Author:
Luo MENG
1
;
Liu BO
;
Liu DI
;
Hu JIAN
;
Long QIAN
;
Zhang QING-BIN
;
Mei HONG
Author Information
1. 贵州省人民医院 胸外科
- Keywords:
thoracoscopic;
non-small-cell lung cancer;
recurrence;
metastasis;
factor analysis
- From:
China Journal of Endoscopy
2017;23(9):42-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the recurrence and metastasis in patients with non-small cell lung cancer (NSCLC) after minimally invasive surgery. Methods 123 patients with NSCLC underwent thoracoscopic lobectomy from January 2008 to December 2013 were enrolled in the study. Their perioperative data and follow-up results were analyzed, and postoperative recurrence and metastasis were recorded. Multivariate logistics regression analysis was performed to investigate the influencing factors of postoperative recurrence and metastasis. Results The median operative time was 165 min (60 ~ 430 min) and the median intraoperative blood loss was 95 ml (20 ~ 3100 ml). Postoperative complications occurred in 15 cases (12.2%). All patients were followed up regularly after discharge, and the median follow-up time was 23.5 months (6 ~ 69 months). During the follow-up period, postoperative recurrence and metastasis occurred in 36 cases (29.3%) and 42 cases (34.1%), including 16 cases (13.0%) patients simultaneously appeared recurrence and metastasis. The ipsilateral lung (52.8%) was the most common site of recurrence, followed by mediastinal lymph nodes (38.9%). Bone (28.6%) was the most common site of metastasis,followed by contralateral lung (26.2%) and brain (19.0%). Multivariate logistic regression analysis showed that stage Ⅱ-Ⅲ, mediastinal lymph node metastasis and low differentiation were independent risk factors of postoperative recurrence (P < 0.05) while stage Ⅱ ~ Ⅲ , number of lymph node metastasis ≥ 3, without postoperative radiotherapy and chemotherapy were independent risk factors of postoperative metastasis (P < 0.05). Conclusions For patients with NSCLC, recurrence and metastasis after thoracoscopic lobectomy occurred mainly in the ipsilateral lung and bone. TNM staging, mediastinal lymph node metastasis, differentiation degree, lymph node metastases, postoperative radiotherapy and chemotherapy were related with postoperative recurrence and metastasis.
