| Objective: The purpose of this study was to investigate the postoperative survival period of patients with NSCLC after radical resection,and to identify the factors affecting the prognosis of patients,so as to provide a basis for improving the prognosis of patients with NSCLC.Methods: Data of 1177 patients with non-small cell lung cancer undergoing radical resection in the affiliated cancer hospital of a medical university from 2005 to 2016 were collected,including demographic information,tumor-related information and treatment plan.Demographic information including: gender,new age,occupation,health care,health belongs to,tumor related information including: comprehensive TNM stage,N stage,tumor location,tumor number,maximum diameter of tumor,pathologic type,differentiation degree,treatment options include: excision method,treatment plan.They were followed up for a long time to record their survival status and follow-up results(survival,death,loss of follow-up,refusal to visit).If the patient died,the date of death and the cause of death were recorded.The starting date of the follow-up was the discharge date of the last confirmed malignant tumor,and the death of the patient was taken as the final outcome of the follow-up.The last follow-up time of the non-fatal patients in this sample was January 31,2018,and the survival period was calculated in years.SPSS19.0software was used for statistical analysis,and test level =0.05.Kaplan-meier method was used to calculate the median survival and total survival,and the survival curve was drawn.Log-rank method was used to test the differences between different subgroups.Significant variables in univariate analysis were incorporated into the Cox risk proportional function model for multivariate analysis.HR>1 considered this variable to be an independent risk factor affecting the prognosis.Results: Among the 1177 patients with NSCLC,443 died,493 survived and 241 were lost to follow-up.Statistical survival situation starting from diagnosis,follow-up deadline is January 31,2018,1 year survival rate was 90%,2 year survival rate was 78%,3 year survival rate was 68%,4 years survival rate was 60%,5-year survival rate was 54%,six years survival rate was 51%,7 years survival rate was 49%,8 years survival rate was47%,9 years survival rate was 45%,the median survival time is 6.46 years.Single factor analysis,the demographic characteristics of gender,age,the survival rate of patients with non-small cell lung cancer radical surgery has an effect(p < 0.05),tumor related information of the largest comprehensive TNM stage,N stage,tumor size,tumor location,,the number of tumor in patients with non-small cell lung cancer radical surgery impacts survival rate(p<0.05),treatment in the treatment of non-small cell lung cancer after radical surgery have influence on survival(p < 0.05).And demographic characteristics of the occupation,state of health care,health belongs to survival in patients with non-small cell lung cancer radical surgery had no effect(p > 0.05),tumor related information of the parts,pathological type,degree of differentiation,survival in patients with non-small cell lung cancer radical surgery has no effect(p > 0.05),tumor resection in the treatment methods in patients with non-small cell lung cancer radical surgery had no effect on survival(p > 0.05).Factors affecting the prognosis of patients undergoing radical resection of non-small cell lung cancer in univariate analysis were incorporated into the Cox risk proportional function model for multivariate analysis.Stepwise regression results showed that the c2 value of Cox regression equation fitting results was 170.963(p =0.001),and the Cox model established had a good regression effect.The risk of death was 1.33 times higher in men than in women(95.0%CI lower: 1.09,95.0%CI upper: 1.64).The patient’s death relative risk of at age 60 and older was 1.548 times higher than that at age 60 and younger(95.0%CI lower: 1.282,95.0%CI upper: 1.87).The patient’s death relative risk of Stage Ⅱ was 1.623 times higher thanⅠ(95.0% CI lower: 1.282,95.0% CI upper: 2.163),The patient’s death relative risk of Stage Ⅲ was 3.184 times higher than Ⅰ(95.0% CI lower: 2.447,95.0%CI upper: 4.141),The patient’s death relative risk of Stage Ⅳ was 5.186 times higher than Ⅰ in the(95.0% CI lower: 3.198,95.0% CI upper: 8.409);The relative risk of death in the 3~5cm group was 1.506 times higher than that in <3cm group(95.0%CI lower:1.143,95.0%CI upper: 1.984),and the relative risk of death in the ≥5cm group was1.870 times higher than that in <3cm group(95.0%CI lower: 1.423,95.0%CI upper:2.534).These results suggest that gender,age,TNM stage and maximum tumor diameter are independent factors affecting the prognosis of patients after radical resection of NSCLC.Proportion of male and female patients with early is similar,but most womenⅠperiod in patients for the first time,while men Ⅲ period patients the most.Less than 60 patients diagnosed,Ⅲ most patients;More than 60 patients diagnosed,Ⅰperiod patients the most.The relationship between TNM stage and survival rate was stratified according to gender and age.The results showed that the survival rate of male patients under 60 years old and female patients over 60 years old decreased significantly with the progress of TNM stage.And 60 years of age or older men and women under the age of 60 patients survival rate is generally also decline with TNM staging,but Ⅲ,Ⅳ short-term survival rate in patients with relatively close.Stratified analysis of the relationship between TNM stage and survival rate according to gender and age showed that the survival rate of patients under 60 years old significantly decreased with the increase of maximum tumor diameter,p < 0.05,which was statistically significant.Although the cumulative survival curve of male patients over 60 years old also showed a tendency to decrease with the increase of the maximum diameter of the tumor,p =0.121,which was not statistically significant.Survival rates were similar in women over 60 years of age with tumors of the largest diameter of 3~5cm compared with those of women over 5cm.Conclusion: Univariate analysis showed that the prognosis of patients after radical resection of non-small cell lung cancer was related to gender,age,TNM comprehensive stage,N stage,maximum tumor diameter,tumor site(upper,middle and lower),number of tumors,operation mode,treatment plan and other factors.The results of multivariate analysis showed that gender,age,TNM staging and maximum tumor diameter were independent factors affecting the prognosis of patients after radical resection of NSCLC.The younger the age of diagnosis is,the earlier the TNM stage is,the smaller the maximum diameter of tumor is,the better the prognosis of patients is,and the survival of patients can be improved through regular physical examination and early diagnosis and treatment of lung cancer.The prognosis of male patients is worse than that of female patients.It is suggested that male patients can establish good living habits and control tobacco inhalation. |
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