[Effect of Thoracic Surgeons on Lung Cancer Patients' Survival]

Zhongguo Fei Ai Za Zhi. 2018 Feb 20;21(2):104-109. doi: 10.3779/j.issn.1009-3419.2018.02.08.
[Article in Chinese]

Abstract

Background: Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact.

Methods: A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients. According to different surgeons grouping doctors to compare the basic information of patients, surgical methods, short-term results and long-term survival differences.

Results: A total of 712 patients treated by 11 experienced thoracic surgeons were included in this study. The patients have nosignificant difference with gender, age, smoking, pathological type between groups. There were significant differences in clinical staging, surgery type, operation time, blood transfusion rate, number of lymph node dissection, palliative resection rate, postoperative complications and perioperative mortality. There was a significant difference in five-year survival rates among patients treated by different doctors. This difference can be seen in all clinical stage analyzes with consistency. In the multivariate analysis, it was suggested that surgeon was an independent factor influencing the prognosis of patients.

Conclusions: Thoracic surgeon has a significant effect on the therapeutic effect of lung cancer patients.

背景与目的 外科医生是肺癌患者手术治疗的直接决策者和执行者,是否医生间的差异会影响到患者生存尚不清楚。本研究分析不同的胸外科医生手术治疗的患者5年生存率,评估医生的影响和作用。方法 回顾性分析2002年-2007年5年间,在中国医学科学院肿瘤医院胸外科进行手术治疗的肺癌患者。依据不同主刀医生进行分组,比较患者基本信息、手术方式、短期结果和长期生存之间的差异。结果 共有11位经验丰富的胸外科医生主刀治疗的712例患者纳入本研究。各位医生诊治患者的性别、年龄、吸烟、病理类型间无明显差异。而在临床分期、手术方式、手术时间、术中输血率、淋巴结清扫个数和姑息性切除比例、术后严重并发症发生率、围手术期死亡率等方面都存在显著差异。不同医生治疗患者5年生存率存在显著差异,这种差异在各临床期别分析中均可见到,具有一致性。多因素分析中提示主刀医生是影响患者预后生存的独立因素。结论 主刀医生对于肺癌患者的治疗效果存在显著影响。.

Keywords: Lung neoplasms; Operation; Prognosis; Surgeon; Surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Surgeons / statistics & numerical data*
  • Survival Analysis
  • Thoracic Surgery*
  • Thoracic Surgical Procedures* / adverse effects