Abstract:
Objective : To investigate the prognostic factors of large cell lung cancer (LCLC) and analyze the efficacy of different postoperative therapeutic strategies on surgery-LCLC. Methods: To collect and retrospectively analyze the clinical data of 80 surgery-LCLC cases between 2000.1 and 2009.12. The prognostic factors and efficacy of different postoperative therapeutic strategies were evaluated by univariate and multivariate analyses. Results: All the 80 cases were diagnosed as stage Ⅰ (21), stage Ⅱ (22), stage Ⅲ (28) and stage Ⅳ (9). 29 cases received no systemic treatment after surgery, 35 received routine chemotherapy, 5 received IFN-α combined with chemotherapy and 11 received cytokine-induced killer cells(CIKs)combined with chemotherapy. The overall 1-, 3- and 5-year survival rates of the 80 LCLC cases were 72.5%, 45.6%, 31.0%, respectively. Cox univariate analysis revealed that N stage (P=0.002), M stage (P<0.001), the clinical stage (P<0.001), surgical methods (P=0.001) and different postoperative therapeutic strategies (P<0.001) were prognostic factors. Cox multivariate analysis indicated that the clinical stage (P<0.001), surgical methods (P=0.034), different postoperative therapeutic therapies (P=0.001) were independent prognostic factors. Further analysis revealed that the overall survival of patients with chemotherapy alone or CIK combined with chemotherapy were significantly higher than those without any postoperative therapy (all P<0.05). After analyzing 43 phase Ⅰ/Ⅱ LCLC cases, we found that the patients undergoing CIK combined with chemotherapy had a better survival than did those without any postoperative treatment or with chemotherapy alone (P=0.004, 0.044, respectively). Analysis of phase Ⅲ/Ⅳ 37 cases revealed that the overall survivals of patients recieving chemotherapy alone or IFN-α combined with chemotherapy, CIK combined with chemotherapy were significantly higher than those without any postoperative therapy (P=0.012, 0.041, 0.011, respectively). Conclusion: The clinical stage, surgical methods, postoperative therapy strategies are independent prognostic factors for LCLC patients. For early or advanced stage LCLC cases, postoperative therapy is also required, with CIK combined chemotherapy superior to chemotherapy alone.