Cemal AKER, Celal Buğra SEZEN, Mustafa Vedat DOGRU, Ece Yasemin DEMİRKOL, Semih ERDUHAN, Melek ERK, Yaşar SÖNMEZOĞLU, Özkan SAYDAM, Levent CANSEVER, Muzaffer METİN

CERRAHİ REZEKSİYON YAPILAN KÜÇÜK HÜCRELİ DIŞI AKCİĞER KANSERLİ KADIN HASTALARDA SAĞKALIMA ETKİ EDEN PROGNOSTİK FAKTÖRLER

Amaç Bu çalışmadaki amacımız, küçük hücreli dışı akciğer kanseri (KHDAK) nedeniyle rezeksiyon uygulanmış hastalarda prognostik faktörlerin cinsiyete bağlı olarak etkilerinin ve kadınlarda sağkalıma etki eden faktörlerin literatür eşliğinde değerlendirilmesidir. Gereç ve Yöntem Çalışmaya Ocak 2007-Aralık 2018 yılları arasında hastanemizde KHDAK nedeniyle akciğer rezeksiyonu uygulanmış hastalar dahil edilmiştir.1491 hasta çalışmaya dahil edilmiştir. Bulgular Hastaların ortalama yaşı 60,0±8,41 (aralık:26-84) yıl idi. 1324 (%88,8) erkek hasta, 167 (%11,2) kadın hasta çalışmada mevcuttu. 406 (%27,2) hastaya pnömonektomi, 1077 (%72,2) hastaya lobektomi ve 8 hastaya (%0,5) segmentektomi yapılmıştır. Ortalama 5 yıllık sağkalım süresi % 57.5 idi. Çalışmada kadın hastaların 5 yıllık sağkalım oranı %66,8 iken erkeklerde %56,4 idi (p=0.005). pN2 durumu değerlendirildiğinde 5 yıllık sağkalım oranı %34,3 iken, pN0 olan hastalarda sağkalım oranı %64,1 olarak saptanmıştır( p<0.001). Cox regresyon analizinde sağkalıma etki eden en önemli prognostik faktörler; cinsiyet, ileri yaş, geniş rezeksiyon yapmak, pN2 varlığı ve ileri evre olarak saptanmıştır. Subgrup analizinde kadın hastalardaki sağkalıma etki eden faktörler değerlendirildiğinde 65 yaş ve üzerinde olan hastalarda 5 yıllık sağkalım oranı %32.9 olarak saptanmıştır (p<0.001). Histopatoloji değerlendirildiğinde adenokarsinomlarda 5 yıllık sağkalım oranı %67,1 iken, skuamöz hücreli kanserlerde %70,7 olarak izlenmiştir. Sonuç Çalışmamız sonucunda kadın hastalarda görülen ana histopatolojik hücretipi adenokarsinomadır. Özellikle kadınlarda ileri yaş, büyük hücreli kanserler, ileri evre ve pN2 durumu sağkalımda kötü prognostik faktörlerdir.

Anahtar Kelimeler:

Akciğer Kanseri, Sağkalım, Prognostik Faktörler

PROGNOSTIC FACTORS FOR THE SURVIVAL OF SURGICALLY TREATED FEMALE PATIENTS FOR NON-SMALL CELL LUNG CANCER

Objective This study aims to evaluate the effects of prognostic factors depending on gender and the factors affecting survival in women patients who underwent resection for non-small cell lung cancer (NSCLC). Material and Methods Patients who underwent lung resection due to NSCLC in our hospital between January 2007 and December 2018 were included in the study. 1491 patients were included in the study. Results The mean age of the patients was 60.0±8.41 (range: 26-84) years. There were 1324 (88.8%) male patients and 167 (11.2%) female patients. Pneumonectomy was performed in 406 (27.2%) patients, lobectomy in 1077 (72.2%) patients, and segmentectomy in 8 patients (0.5%). The mean 5-year survival time was 57.5%. In the study, the 5-year survival rate of female patients was 66.8%, while it was 56.4% in males (p=0.005). When the pN2 status was evaluated, the 5-year survival rate was 34.3%, while the survival rate was 64.1% in patients with pN0 (p<0.001). The most important prognostic factors affecting survival in Cox regression analysis were gender, advanced age, wider resection, pN2, and advanced stage. When the factors affecting survival in female patients were evaluated in the subgroup analysis, the 5-year survival rate was 32.9% in patients aged 65 and over (p<0.001). When the histopathology was evaluated, the 5-year survival rate was 67.1% in adenocarcinomas, while 70.7% in squamous cell cancers. Conclusion As a result of our study, the main histopathological cell type seen in female patients is adenocarcinoma. Especially in women, advanced age, large cell cancers, advanced stage, and pN2 status are poor prognostic factors in survival.

Keywords:

Lung Cancer, Survival, Prognostic Factors,

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