İrfan TAŞTEPE, Sadi KAYA, Ertan AYDIN, Nurettin KARAOĞLANOĞLU, Ülkü YAZICI

Clinical characteristics and prognosis of pulmonary pleomorphic carcinoma: Retrospective analysis of 57 patients

Amaç: Bu çalışmada pulmoner pleomorfik karsinomun kliniközellikleri ve prognozu değerlendirildi.Çalışmaplanı: Çalışmaya pleomorfik karsinom nedeniile ameliyat edilen 57 hasta (54 erkek, 3 kadın; ort. yaş60.4 yıl; dağılım 33-75 yıl) dahil edildi. Kliniğimizde1999-2009 yılları arasında pleomorfik karsinom tanısıylaopere edilen hastalar çalışmaya alındı. Tüm veriler hastadosyalarından retrospektif olarak kaydedildi.Bul gu lar: Hastaların 54ü sigara içmekte (ortalama49.9 paket/yıl) idi. En yaygın semptomlar hemoptizive öksürük idi ve 51 hasta asemptomatik idi. Tümhastaların tanısı pleomorfik karsinom olarak ameliyatsonrası doğrulandı. Uygulanan cerrahi yaklaşımlar beşparenkim koruyucu rezeksiyon, 35 lobektomi, yedibilobektomi ve bir torakoskopik biyopsi idi. Epitelyalkomponentlerin 28i adenokarsinom, 15i epidermoidkarsinom, altısı büyük hücreli karsinom iken, sarkomatoidkomponentlerin 28inde iğsi hücreler, 22sinde devhücreler, yedisinde ise iğsi ve dev hücrelerin karışımıvar idi. Takip süresi sonunda 28 ölüm kaydedildi.Ortalama sağkalım 62 ay idi.Sonuç: Cerrahi ve adjuvan kemoradyoterapiye rağmen,pleomorfik karsinom sık uzak metastaza bağlı olarak kötüprognoz ile ilişkilendirilmektedir. Evreleme özellikle N 0hastalarda önemli bir prognostik faktör olarak gözükmektedir.

Pulmo nerpleo morfik karsinomun klinik özellikleri ve prognozu: 57 hastanın retrospektif analizi

Background: This study aims to evaluate clinical characteristicsand prognosis of pulmonary pleomorphic carcinoma.Methods: The study included 57 patients (54 males, 3 females;mean age 60.4 years; range 33 to 75 years) operated forpleomorphic carcinoma. The patients who underwent surgerywith the diagnosis of pleomorphic carcinoma in our clinicbetween 1999 and 2009 were recruited to the study. Dataswere recorded retrospectively from the patient files.Results: Of all patients, 54 were smokers (mean 49.9 packets/year). Most common symptoms were hemoptysis and cough,and 51 patients were asymptomatic. All patients diagnoseswere confirmed postoperatively as pleomorphic carcinoma.Surgical approaches applied were five parenchyma sparingresections, 35 lobectomies, seven bilobectomies, and onethoracoscopic biopsy. Of epithelial components, 28 wereadenocarcinomas, 15 were epidermoid carcinomas, andsix were large cell carcinomas; whereas of sarcomatoidcomponents, 28 had spindle cells, 22 had giant cells, andseven had a mix of spindle and giant cells. At the end of thefollow-up period, 28 deaths were recorded. Mean survivalwas 62 months.Conclusion: Despite surgery and adjuvant chemoradiotherapy,pleomorphic carcinoma is associated with poor prognosisbecause of frequent distant metastasis. Staging seems to be animportant prognostic factor, particularly in N 0 patients.

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