Ayşe ERGÖNÜL, Mithat FAZLIOĞLU, Celalettin KOCATÜRK, Akif TURNA, Mehmet Ali BEDİRHAN

Rezeke edilen erken evre küçük hücreli dışı akciğer karsinomunda prognostik faktörler ve 10 yıllık sağ kalım

Amaç: Akciğer kanseri dünyada kanserden ölümlerin ilk sırasında yer almaktadır. Günümüzde yeni geliĢen tanısal metotlara, ilerlemiĢ cerrahi tekniklere ve cerrahi dıĢı tedavi yöntemlerindeki geliĢmelere rağmen, genel olarak akciğer kanserinin beĢ yıllık kümülatif sağ kalımı hala %14’tür. Gereç ve Yöntem: Postoperatif histopatolojik inceleme sonucunda erken evre (Evre I - II) olarak değerlendirilen 207 olgunun kayıtları retrospektif olarak gözden geçirildi. ÇalıĢmamızda olgularımızın yaĢ, cins, solunum fonksiyonları, Ģikayetleri, postoperatif komplikasyonlar, tümörün evresi ve histopatolojik tipinin prognoza ve sağ kalıma olan etkileri araĢtırılmıĢtır. Bulgular: ÇalıĢmamızda düĢük evre tümörlerde cinsiyet, tanı sırasında Ģikâyeti olma/olmama durumu, göğüs ağrısı, hemoptizi, balgam, dispne ve sigara anamnezi sağ kalımı istatistiksel olarak etkilememiĢtir. TNM evresi ve postoperatif komplikasyon varlığı sağ kalım süresini anlamlı olarak etkilemiĢtir. Sonuç: Küçük hücreli dıĢı akciğer kanserinde (KHDAK) küratif tedavi Ģekli cerrahidir. KHDAK’li hastaların prognozunu belirleyen en önemli kriter evredir.

Prognostic factors and 10 years survival analysis that operated early stage non-small cell lung carcinoma

Aim: Lung cancer is at the beginning causes of deaths from cancer in the world. Despite recent advances in diagnostic methods, advanced surgical techniques, and non-surgical methods of treatment, overall 5-year cumulative survival of lung cancer is still 14%. Materials and Methods: As a result of postoperative histopathological examination, the records of 207 patients who were evaluated as early stage (stage I and II) were retrospectively reviewed. We investigated the age, gender, respiratory functions, complaints, and postoperative complications, prognosis of the tumor stage and histopathologic type and the effects of survival in our study. Results: Low grade tumors, gender, presence / absence of complaints during diagnosis, chest pain, hemoptysis, sputum, dyspnea and smoking history did not affect survival statistically. TNM stage and postoperative complications significantly affected the survival time. Conclusion: Curative therapy in non-small cell lung cancer is surgery. The most important criteria determining the prognosis of patients is stage.

PDF

___

1. Anthony B Miller. Lung Cancer, Epidemiology in Thoracic Surgery, Churchill Livingstone Inc.ed. F.G.Pearson 1995; 27: 648-60.
2. Lynn T, Tanoue and Richard A Matthay. Lung Cancer, Epidemiology and carcinogenesis in General Thoracic Surgery, 5 th ed. Philadelphia: Lippincott Williams & Wilkins ed T.W.Shields; 2000; 93: 1215-28.
3. Gail Darling and Carolyn M Dresler. Clinical Presentation of Lung Cancer in Thoracic Surgery, Churchill Livingstone Inc.ed. F.G.Pearson; 96: 1269-71.
4. Cicero JL, Ponn RB, Daly DT. Surgical Treatment of nonsmall cell lung cancer in General Thoracic Surgery, 5 th ed. Philadelphia: Lippincott Williams & Wilkins ed T.W.Shields; 2000;99: 1311-41.
5. Darling G, Dresler CM. Clinical presentation of lung cancer in General Thoracic Surgery, 5 th ed. Philadelphia: Lippincott Williams & Wilkins ed T.W.Shields; 2000; 96: 1269-82.
6. Ginsberg RJ, Rubinstein L. For the Lung Cancer Study Group. Randomized trial of lobectomy versus limited resection for patients with T1N0 nonsmall cell lung cancer. Ann.Thorac Surg 1995; 60: 615-23.
7. Steinbaum SS, Uretzky ID, McAdams HP. Exploratory thoracotomy for nonresectable lung cancer. Chest 1995 Apr; 107 (4): 1058-61.
8. Watanabe Y, Tsubota M, Shimizu J et al. Aggressive surgical intervention in N2 nonsmall cell carcinoma of the lung with mediastinal lymph node metastasis. Ann Thorac Surg 1991; 51: 253.
9. Myrdal G, Gustafsson G, Lambe M. Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity. European Journal of Cardio-thoracic Surgery 2001; 20: 694-9.
10. Fang D, Zhang D, Guojun H. Results of surgical resection of patients with primary lung cancer: T a retrospective analysis of 1905 cases. Ann Thorac Surg. 2001; 72: 1155-9.
11. Tanaka F, Yanagihara K, Otake Y, et al. Prognostic factors in patients with resected pathologic (p-) T1- 2N1M0 non-small cell lung cancer. European Journal of cardio-thoracic surgery 2001; 19: 555-61.
12. Cicero L, Ponn RB, Daly DT. Surgical Treatment of nonsmall cell lung cancer in General Thoracic Surgery, 5 th ed. Philadelphia: Lippincott Williams & Wilkins ed T.W.Shields; 2000;99: 1321-41.
13. Ratto GB, Fabiano F, Rovida S. Survival after incomplete resection or exploratory thoracotomy in patients with advanced non small cell lung cancer. Ital J. Surg Sci. 1988; 18 (4): 377-83.
14. Hara N, Ohta M, Tanaka K, Ichinose Y. Assessment of the role of surgery for stage III bronchogenic carcinoma. J. of surgical oncology 1984 Mar; 25 (3): 153-8.
15. Bosch Den Van JM et al. Failure of preoperative staging to asssess unresectability in M0 bronchogenic carcinoma CANCER 1989; 63.
16. Steinbaum SS, Uretzky ID, McAdams HP. Exploratory thoracotomy for nonresectable lung cancer. Chest 1995 Apr; 107 (4): 1058-61.
17. TNM classification of malignant tumors. 5th ed. Willey-Liss, New York: 1997; 93-7.
18. Travis WD, Colby TV, et al. World Health Organization International Histological Classification of Tumours. 2nd ed. Berlin-Heidelberg,1999.
19. Watanabe Y, Hayashi, Shimizu J, Oda M, Iwa T. Mediastinal nodal involvement and the prognosis of nonsmall cell lung cancer. Chest 1991; 100: 423-8.
20. Çıkrıkçıoğlu S, Kıyık M, S.Altın, Gürses A. Akciğer kanserinde prognostik faktörler ve tedavi öncesi değerlendirme. Akciğer kanseri multidisipliner yaklaĢım, Toraks Derneği Ankara 1999; 80-96.