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目的探讨影响70岁以上老年非小细胞肺癌(NSCLC)患者预后生存的因素。方法回顾性分析2005年1月至2006年12月收治的361例70岁以上老年NSCLC患者的临床资料,随访生存情况,分析年龄、性别、吸烟状况、Karnofsky评分(KPS)、TNM分期、病理类型、治疗方式、合并症情况(Charlson合并症指数CCI)等因素,对老年非小细胞肺癌患者生存期的影响。结果全组患者平均年龄(73.4±3.1)岁(70～86岁),确诊肺癌后中位生存期34.0个月(0.3～83.0个月),5年生存率34.1%。对年龄、性别、病理类型、是否吸烟、KPS、TNM分期、治疗方式、是否伴有合并症等预后因素进行单因素分析,结果显示:TNM分期、治疗方式、KPS、是否伴有合并症与预后相关。Cox多因素分析显示TNM分期、有无合并症、治疗方式是影响患者生存及预后的独立因素。结论 TNM分期、治疗方式、合并症等多种因素影响70岁以上老年NSCLC患者的预后生存。老年肺癌患者多伴有合并症,重视并积极控制合并症,有助于改善预后,延长生存。
Objective To explore the factors influencing the prognosis of elderly patients with non-small cell lung cancer (NSCLC) over 70 years of age. Methods The clinical data of 361 elderly NSCLC patients over 70 years of age from January 2005 to December 2006 were retrospectively analyzed. The survival, follow-up, age, sex, smoking status, Karnofsky score, TNM stage, pathological type , Treatment, complications (Charlson’s comorbidity index CCI) and other factors on the survival of elderly patients with non-small cell lung cancer. Results The mean age of all patients was 73.4 ± 3.1 years (ranged from 70 to 86 years). The median survival time was 34.0 months (0.3 to 83.0 months) after diagnosis of lung cancer, and the 5-year survival rate was 34.1%. Univariate analysis of prognostic factors such as age, sex, pathological type, smoking, KPS, TNM staging, treatment modality and comorbidities showed that TNM staging, treatment modalities, KPS, complication and prognosis Related. Cox multivariate analysis showed TNM staging, with or without complications, treatment is an independent factor affecting the survival and prognosis of patients. Conclusions Various factors such as TNM staging, treatment modalities and comorbidities affect the prognosis of elderly patients over 70 years of age with NSCLC. Elderly patients with lung cancer often accompanied by complications, attention and active control of complications, helps to improve the prognosis and prolong survival.