Tuberculosis and Respiratory Diseases
- 제53권4호
- /
- Pages.379-388
- /
- 2002
- /
- 1738-3536(pISSN)
- /
- 2005-6184(eISSN)
제 IV병기 비소세포폐암의 예후인자
Prognostic Factors for Survival in Patients with Stage IV non-small Cell Lung Cancer
- 김명훈 (충남대학교 의과대학 내과학교실) ;
- 박희선 (충남대학교 의과대학 내과학교실) ;
- 강현모 (충남대학교 의과대학 내과학교실) ;
- 장필순 (충남대학교 의과대학 내과학교실) ;
- 이연선 (충남대학교 의과대학 내과학교실) ;
- 안진영 (충남대학교 의과대학 내과학교실) ;
- 권선중 (충남대학교 의과대학 내과학교실) ;
- 정성수 (충남대학교 의과대학 내과학교실) ;
- 김주옥 (충남대학교 의과대학 내과학교실) ;
- 김선영 (충남대학교 의과대학 내과학교실)
- Kim, Myung-Hoon (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Park, Hee-Sun (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Kang, Hyun-Mo (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Jang, Pil-Soon (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Lee, Yun-Sun (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- An, Jin-Yong (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Kwon, Sun-Jung (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Jung, Sung-Soo (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Kim, Ju-Ock (Department of Internal Medicine, College of Medicine, Chungnam National University) ;
- Kim, Sun-Young (Department of Internal Medicine, College of Medicine, Chungnam National University)
- 발행 : 2002.10.30
초록
연구배경 : 폐암 중 80%를 차지하는 비소세포폐암은 발견 당시부터 전이성 병변이 있는 IV기로 진단되는 경우가 적지 않다. 그러나 그동안 IV병기 비소세포폐암의 예후인자에 대한 조사는 충분하지 않았었다. 이에 저자들은 IV병기 비소세포폐암으로 진단을 받은 환자들을 대상으로 생존기간에 영향을 미치는 예후인자의 분석과 M1으로 평가되는 전이 장기에 따른 생존기간의 차이를 조사하고자 하였다. 방 법 : 1997년 1월부터 2000년 12월까지 충남대학교병원에 내원해서 병리조직학적으로 IV병기 비소세포폐 암으로 진단을 받은 151명을 대상으로 하였고, 의무기록을 통한 후향적인 방법으로 분석하였다. 결 과 : 1) 생존기간에 대한 단변수 분석 결과 연령, 신체 활동도, 혈청 알부민 농도, 체중감소,
Background : Although patients with stage IV non-small cell lung cancer are known to have a poor prognosis, the prognostic factors for survival have not been well evaluated. Such factors may be different from those for overall survival. This study was performed to analyze the prognostic factors for survuval and the variation of survival according to metastatic organ, in patients with stage IV non-small cell lung cancer. Materials and Methods : From January 1997 to December 2000, 151 patients with confirmed stage IV non-small cell lung cancer were enrolled into this study retrospectively. The clinical and laboratory data were analyzed using univareate Kaplan-Meied and Multivariate Cox regression models. Results : On univariate analysis, age, performance status, serum albumin level, weight loss, forced expiratory volume in one second (FEV1), systemic chemotherapy, the number of metastatic organs and serum lactate dehydrogenase (LDH) level were significant factors (p<0.05). In multivariate analysis, important factors for survival were ECOG performance (relative risk of death [RR]: 2.709), systemic chemotherapy (RR: 1.944), serum LDH level (RR: 1.819) and FEV1 (RR: 1.774) (p<0.05), Metastasis to the brain and liver was also a significant factor on univariate analysis). The presence of single lung metastasis was associated with better survival than that of other metastatic organs (p=0.000). Conclusion : We confirmed that performance status and systemic chemotherapy were independent prognostic factors, as has been recognized. The survival of stage IV non-small cell lung cancer patients was different according to the metastatic organs. Among the metastatic sites, only patients with metastasis to the lung showed bettrer survival than that of other sites, while metastasis of the brain or liver was associated with worse survival than that of other sites.