Abstract
背景与目的目前，肺叶切除与亚肺叶切除治疗Ia期小细胞肺癌（small cell lung cancer, SCLC）的预后比较鲜有报道。本研究通过对年龄≥60岁的T1N0M0（≤3 cm）SCLC进行回顾性研究，旨在探索肺叶切除与亚肺叶切除治疗Ia期SCLC预后的对比分析。方法纳入“监测，流行病学和结果数据库”（Surveillance, Epidemiology and End Results database, SEER）在1992年-2010年间经病理诊断为Ia期SCLC患者共515例，数据使用Kaplan-Meier（Log-rank检验）和Cox模型进行比较统计分析。结果肺叶切除组（n=110）、亚肺叶切除组（n=57）、和非手术治疗组（n=348）的中位生存期分别为45个月、23个月和16个月；该三组相应的5年总生存期（OS）分别为44%、30%和14%（Lob vs Sub, χ2=4.851, P=0.028; Sub vs non-surgical, χ2=6.529, P=0.011）。SCLC有、无淋巴结采样/清扫患者的预后无显著差异（P=0.107）；肺叶切除+放化疗组（Lob+CR, n=59）的5年OS为50%。Cox分析证实，手术（肺叶与亚肺叶切除术）方式为独立预后预测因素之一。结论年龄≥60岁的Ia期SCLC患者，我们推荐解剖性肺叶切除联合辅助放化疗治疗。
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