Kamil KAYNAK, Ahmet DEMİRKAYA, Hasan TÜZÜN, Gökçe CANGEL, Özkan DEMİRHAN, Akif TURNA

Akciğer metastazı rezeksiyonunun sonuçları ve prognostik faktörler

Amaç: Bu çalışmada, metastazektominin sağkalım sonuçları ve sağkalımı etkileyen prognostik faktörler araştırıldı.Çalışmaplanı:Ocak 2004 ile Mart 2012 tarihleri arasında, kliniğimizde metastatik akciğer hastalığı nedeni ile ameliyat edilmiş toplam 85 hasta (44 erkek, 41 kadın; ort. yaş 51 yıl; dağılım, 15-85 yıl) retrospektif olarak incelendi. Klinik ve radyolojik bulguların cerrahi sonrası sonuçlara olan muhtemel etkileri değerlendirildi.Bul gu lar: Seksen beş hastaya toplam 118 cerrahi işlem uygulandı. En sık uygulanan girişim; 104 hastaya (%88) torakotomi idi. İkinci en sık uygulanan girişim ise, 12 hastada (%10) video yardımlı torakoskopik cerrahi idi. Akciğer metastazektomisi yapılan hastalarda üç yıllık sağkalım oranı %85, beş yıllık sağkalım oranı ise %62.5 idi. Üç yıllık sağkalım primer karsinomlu hastalarda %76, karsinom olmayanlarda ise %37 olarak tespit edildi. Kolorektal karsinomlu hastalarda lenf nodu tutulumunun anlamlı bir prognostik faktör olmadığı belirlendi (p>0.05). Meme karsinomunun akciğer metastazı nedeni ile ameliyat edilmiş hastalarda ortalama sağkalım 35±2.1 ay, iki yıllık sağkalım ise %50 olarak bulundu.So nuç: Akciğer metastazektomisi yapılan hastalarda iyi sağkalım oranı elde edilebilir. Sağkalımı belirleyen esas prognostik faktörün, primer tümörün histopatolojisi olduğu düşünülmektedir.

Results of resection of pulmonary metastasis and prognostic factors

Background: In this study, we investigated the survival outcomes of metastasectomy and prognostic factors affecting survival. Methods: Between January 2004 and March 2012, a total of 85 patients (44 males, 41 females; mean age 51 years; range 15 to 85 years) who were operated for metastatic lung disease in our clinic were retrospectively analyzed. Possible effects of clinical and radiological findings on postoperative outcomes were assessed. Results: A total of 118 surgical procedures were performed in 85 patients. Thoracotomy was the most common intervention performed in 104 patients (88%). The second most frequent intervention was video-assisted thoracoscopic surgery in 12 patients (10%). Three-year survival rate was 85%, while five-year survival rate was 62.5% in patients undergoing lung metastasectomy. Three- year survival was found to be 76% in patients with primary carcinoma and 37% in non-carcinoma patients. Lymph node involvement was not found to be a prognostic factor in patients with colorectal carcinoma (p>0.05). The mean survival was 35±2.1 months and two-year survival was 50% in patients who were operated for metastatic lung disease of breast carcinoma. Conclusion: Good survival rates can be achieved in patients undergoing lung metastasectomy. We believe that histopathology of the primary tumor is the main prognostic factor for survival.

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