가천의대 길병원에서 진단된 폐암 환자의 임상적 특성
Clinical characteristics of lung cancer diagnosed from 2006 to 2008: Data from Gachon University Gil Hospital
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목적: 가천의과학대학교 길병원에서 2006년 1월부터 2008년 12월까지 진단된 폐암의 임상양상을 알기 위해 본 조사를 시행하였다. 방법: 폐암으로 등록된 환자를 대상으로 하였으며 임상양상을 의무기록을 중심으로 후향적으로 분석하였다. 결과: 총 713명이 폐암으로 진단되었으며 환자의 중앙연령은 69세였으며 60세 이상의 환자가 전체의 78.1%를 차지했다. 남성이 73.1%였으며, 흡연자는 58.2%였다. 조직형 중 선암이 32.7%로 가장 많았으며 그 다음으로 편평세포암종이 25.9%, 조직형이 불분명한 비소세포암 17.3%, 소세포암 15.0%, 대세포암 1.7%, 기타 3.1% 순이었다. 비소세포암 중 진단 당시 병기는 IA (1.5%), IB (5.6%), IIA (1.3%), IIB (4.3%), IIIA (5.4%), IIIB (23.1%), IV (47.7%)를 보였고, 소세포 폐암은 제한기 20.6%, 확장기 76.6%를 보였다. 최초 치료로 수술을 받은 경우가 9.8%였고, 항암화학요법과 방사선 병합요법 6.7%, 방사선 단독요법 5.9%, 항암화학요법을 받은 경우가 32.4%, 보존적 치료는 29.7%였다. 중앙 생존 기간은 15.3개월이었으며(95% 신뢰구간: 11.5~19.1개월) 조직별 소그룹 분석에서 선암은 35.0개월, 비소세포암 14.2개월, 편평상피세포암 13.5개월, 소세포암이 11.8개월로 조직형에 따라 유의한 차이를 보였다(p=0.0445). 결론: 조직형 중에서 선암이 가장 높은 빈도를 보였으며 대부분의 환자(78.1%)가 60세 이상의 고령이었으며 III/IV 병기(76.3%)였다. 조직에 따른 중앙 생존 기간은 선암에서 다른 조직형에 비해 유의하게 길었다.
Abstract
Background/Aims: This study examined the clinical characteristics of patients with lung cancer who were diagnosed at the Gachon University of Medicine and Science Gil Hospital from January 2006 to December 2008. Methods: The lung cancer data were downloaded from the hospital medical information system using cancer registration information. The patient clinical characteristics were analyzed retrospectively. Results: A total of 713 patients were diagnosed with lung cancer. Their median age was 69 years, 78.1% were over 60 years old, and 73.1% and 58.2% were men and smokers, respectively. Adenocarcinoma (32.7%) was the most common histologic type, followed by squamous carcinoma (25.9%), unclassifiable non-small-cell lung cancer (NSCLC) (17.3%), and small-cell carcinoma (SCLC) (15.0%). In the NSCLC group, the stage at diagnosis was IA (1.5%), IB (5.6%), IIA (1.3%), IIB (4.3%), IIIA (5.4%), IIIB (23.1%), IV (47.7%), and unknown (11.1%). In the SCLC group, 20.6% of the patients were in the limited stage, 76.6% were in the extensive stage, and 2.8% were unknown. The patients were treated by surgery (9.8%), concurrent chemoradiotherapy (6.7%), radiotherapy only (5.9%), chemotherapy (32.4%), or best supportive care only (29.7%). The median overall survival was 15.3 months (95% CI, 11.5~19.1). The median survival based on histology was adenocarcinoma (35.0 months), squamous (13.5 months), NSCLC (14.2 months), and SCLC (11.8 months) (p=0.0445). Conclusions: Adenocarcinoma was the most common histologic type at our institute. Most patients were over 60 years of age (78.1%) and had stage III/IV (76.3%) cancer. The survival of patients with adenocarcinoma was longer than that for the other histological types.
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