Levent CANSEVER, Celal Buğra SEZEN, Muzaffer METİN, Cemal AKER, Aysun ÖLÇMEN, Volkan ERDOĞU, Özkan SAYDAM, Mustafa Vedat DOĞRU

İndüksiyon tedavisi sonrasında cerrahi patolojik tam yanıt alınan akciğer kanserlerinde prognostik faktörlerin değerlendirilmesi

Amaç: Bu çalışmada, patolojik tam yanıt veren küçük hücreli dışı akciğer kanserli hastalarda indüksiyon tedavisinin uzun dönem sonuçları değerlendirildi ve sağkalımı etkileyen prognostik faktörler araştırıldı. Çalışma planı: Ocak 2010 ve Aralık 2017 tarihleri arasında indüksiyon tedavisi verilen ve indüksiyon tedavisinden sonra ameliyat edilen ve patolojik tam yanıt veren ileri evre (IIIA-IIIB) küçük hücreli dışı akciğer kanseri olan toplam 39 hasta (38 erkek, 1 kadın; ort. yaş: 56.2±8.3 yıl; dağılım 38-77 yıl) retrospektif olarak incelendi. Hastaların sağkalım oranları ve sağkalımın prognostik faktörleri değerlendirildi. Bulgular: İndüksiyon tedavisi öncesi klinik evrelemede üç (%7.7) hastada Evre IIB, 26 (%66.7) hastada Evre IIIA, ve 10 (%25.6) hastada Evre IIIB hastalık izlendi. Beş yıllık sağkalım oranı %61.2 olup, hastalıksız sağkalım oranı %55.1 idi. Dokuz (%23.1) hastada, ameliyat sonrası dönemde lokal nüks veya uzak nüks saptandı. Sonuç: İndüksiyon tedavisi sonrası ameliyat edilen lokal ileri evre küçük hücreli dışı akciğer kanserli hastalarda, patolojik tam yanıt oranı azımsanamayacak düzeydedir. Bu hastalarda beş yıllık genel sağkalım oldukça memnun edici olup, genel sağkalımı etkileyen en önemli prognostik faktör tek istasyon N2 varlığıdır.

Evaluation of prognostic factors in lung cancers with surgical complete response after induction treatment

Background: This study aims to evaluate long-term results of induction treatment and to investigate prognostic factors affecting survival in non-small cell lung cancer patients with a pathological complete response. Methods: Between January 2010 and December 2017, a total of 39 patients (38 males, 1 female; mean age: 56.2±8.3 years; range, 38 to 77 years) having locally advanced (IIIA-IIIB) non-small cell lung cancer who were given induction treatment and underwent surgery after induction treatment and had a pathological complete response were retrospectively analyzed. Survival rates of the patients and prognostic factors of survival were analyzed. Results: Clinical staging before induction treatment revealed Stage IIB, IIIA, and IIIB disease in three (7.7%), 26 (66.7%), and 10 (25.6%) patients, respectively. The five-year overall survival rate was 61.2%, and the disease-free survival rate was 55.1%. In nine (23.1%) patients, local and distant recurrences were detected in the postoperative period. Conclusion: In patients with locally advanced non-small cell lung cancer undergoing surgery after induction treatment, the rates of pathological complete response are at considerable levels. In these patients, the five-year overall survival is quite satisfactory and the most important prognostic factor affecting overall survival is the presence of single-station N2.

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