Lung Cancer Survival Improvement through Surgical Intervention in PUMCH Hospital

摘要

Objective: To investigate and evaluate improvement of lung cancer survival after surgical intervention in PUMC hospital during the last 15 years. Methods: From January 1989 to December 2003, 1574 lung cancer cases underwent surgical treatment and followed up. All cases in this series were divided into two groups according to time period: group A (1999-2003) and group B (1989-1998). The difference in the survival rate between groups A and B was compared. Results: The morbidity and mortality in group A was decreased significantly in comparison to group B (11.2% vs. 19.2%, 1.06% vs. 1.93%, respectively). However, the 3-year and 5-year survival rate was increased from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively. A significant improvement in survival was observed in patients with stage Ⅰ, Ⅱ and ⅢA, but not in those with stage ⅢB and Ⅳ. Also, patients with lobectomy had more satisfactory results than those receiving exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection. Conclusion: Lobectomy plus systematic mediastinal lymph nodes dissection has become the standard mode for resectable lung cancer. Combination of complete resection along with lymph nodal dissection, and postoperative adjuvant chemotherapy based on platinum/3rd generation chemotherapy medicine, has preliminarily been justified, proving an important approach for effective improvement in long-term survival of non-small cell lung carcinoma.