Kenan Can CEYLAN, Onur AKÇAY, Şaban ÜNSAL, Özgür SAMANCILAR, Şeyda ÖRS KAYA

Küçük hücreli dışı akciğer kanserinde endobronşiyal lezyon lenf nodu durumunu etkiler mi?

Amaç: Bu çalışmada küçük hücreli dışı akciğer kanserinde endobronşiyal lezyon ile hiler veya mediastinal lenf nodu metastazı arasında ilişki olup olmadığı değerlendirildi. Çalışma planı: Ocak 2005 - Aralık 2011 tarihleri arasında küçük hücreli dışı akciğer kanseri tanısı ile anatomik rezeksiyon uygulanmış toplam 687 hasta (636 erkek, 51 kadın; ort. yaş 60.8±9.1 yıl; dağılım 29-82 yıl) retrospektif olarak incelendi. Bronkoskopik olarak saptanmış endobronşiyal lezyonu olan ve olmayan hastalar iki gruba ayrıldı. İki grup, hiler veya aynı taraf mediastinal lenf nodu metastazı olup olmaması yönünden karşılaştırıldı. Bulgular: Endobronşiyal lezyonu olan (n=174) ve olmayan hasta gruplarında (n=513) ki-kare analizi ile yapılan değerlendirmede endobronşiyal lezyon varlığı ve hiler lenf nodu metastazı durumu arasında anlamlı bir ilişki saptanır iken (p=0.014) endobronşiyal lezyon varlığı ve aynı taraf mediastinal lenf nodu metastazı durumu arasında anlamlı bir ilişki saptanmadı (p=0.383). Endobronşiyal lezyonu olan ve olmayan hastalarda beş yıllık sağkalım sırası ile %58.6 ve %40.2 olup aralarında istatistiksel olarak anlamlı farklılık vardı (p

Does endobronchial lesion affect the lymph node status in non-small cell lung cancer?

Background: This study aims to evaluate whether or not there is a relationship between endobronchial lesion and hilar and/or mediastinal lymph node metastasis in non-small cell lung cancer.Methods: A total of 687 patients (636 males, 51 females; mean age 60.8±9.1 years; range 29 to 82 years) who were performed anatomical resection with the diagnosis of non-small cell lung cancer between January 2005 and December 2011 were analyzed retrospectively. Patients with or without bronchoscopically detected endobronchial lesion were divided into two groups. The two groups were compared in terms of having or not having hilar or ipsilateral mediastinal lymph node metastasis.Results: As a result of an evaluation with chi-square analysis performed on patient groups with (n=174) or without (n=513) endobronchial lesion, we detected a significant correlation between the presence of endobronchial lesion and hilar lymph node metastasis status (p=0.014), while we did not detect a significant correlation between the presence of endobronchial lesion and ipsilateral mediastinal lymph node metastasis status (p=0.383). Five-year survival in patients with or without endobronchial lesion was 58.6% and 40.2%, respectively, with a statistically significant correlation (p

PDF

___

19. Chabowski M, Orłowski TM, Rabczenko D. Analysis of prognostic factors and efficacy of surgical treatment for non-small cell lung cancer: department of surgery NTLDRI (1998-1999). Pneumonol Alergol Pol 2008;76:1-10. [Abstract]
18. Fry WA, Phillips JL, Menck HR. Ten-year survey of lung cancer treatment and survival in hospitals in the United States: a national cancer data base report. Cancer 1999;86:1867-76.
17. Okamoto T, Maruyama R, Suemitsu R, Aoki Y, Wataya H, Kojo M, et al. Prognostic value of the histological subtype in completely resected non-small cell lung cancer. Interact Cardiovasc Thorac Surg 2006;5:362-6.
16. Carbone E, Asamura H, Takei H, Kondo H, Suzuki K, Miyaoka E, et al. T2 tumors larger than five centimeters in diameter can be upgraded to T3 in non-small cell lung cancer. J Thorac Cardiovasc Surg 2001;122:907-12.
15. Brooks DR, Austin JH, Heelan RT, Ginsberg MS, Shin V, Olson SH, et al. Influence of type of cigarette on peripheral versus central lung cancer. Cancer Epidemiol Biomarkers Prev 2005;14:576-81.
14. Watanabe Y, Murakami S, Oda M, Ohta Y, Watanabe S, Nozaki Z, et al. Surgical management of early stage central (hilar) and peripheral nonsmall cell lung carcinoma. Cancer 2000;89:2438-44.
13. Uslu Ö, Günaçtı E, Tuksavul F, Gülpek M, Vatansever T, Güçlü S. The relationship of endobronchial appearance with histopathological sub-type in lung cancer. İzmir Göğüs Hastanesi Dergisi 2005;19:1-5.
12. Tateishi M, Fukuyama Y, Hamatake M, Kohdono S, Ishida T, Sugimachi K. Skip mediastinal lymph node metastasis in non-small cell lung cancer. J Surg Oncol 1994;57:139-42.
11. Marra A, Hillejan L, Zaboura G, Fujimoto T, Greschuchna D, Stamatis G. Pathologic N1 non-small cell lung cancer: correlation between pattern of lymphatic spread and prognosis. J Thorac Cardiovasc Surg 2003;125:543-53.
10. Ito M, Yamashita Y, Miyata Y, Ohara M, Tsutani Y, Ikeda T, et al. Prognostic impact of the primary tumor location based on the hilar structures in non-small cell lung cancer with mediastinal lymph node metastasis. Lung Cancer 2012;76:93-7.
9. Graham AN, Chan KJ, Pastorino U, Goldstraw P. Systematic nodal dissection in the intrathoracic staging of patients with non-small cell lung cancer. J Thorac Cardiovasc Surg 1999;117:246-51.
8. Krdzalic G, Mesic D, Iljazovic E, Brkic S, Krdzalic A, Ramic N, et al. Mediastinal lymph node metastasis pattern in clinically N0 non-small- cell lung cancer patients who underwent surgical resection. Med Arh 2010;64:332-4.
7. Ketchedjian A, Daly BD, Fernando HC, Florin L, Hunter CJ, Morelli DM, et al. Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma. J Thorac Cardiovasc Surg 2006;132:544-8.
6. Sihoe AD, Yim AP. Lung cancer staging. J Surg Res 2004;117:92-106.
5. Yılmaz HÖ, Saygı A, Sarıman N, Maraşlı D, Düzgün Y, Köksal H. Relationship of T-stage and nodal metastases according to the up-to-date clinical TNM staging in lung cancer. Turk Gogus Kalp Dama 2012;20:101-6.
4. Scagliotti G. Symptoms, signs and staging of lung cancer. Eur Respir Mon 2001;17:86-119.
3. Casali C, Stefani A, Morandi U. N1 non-small-cell lung cancer. A 20-year surgical experience. Asian Cardiovasc Thorac Ann 2011;19:217-24.
2. Shields TW. The significance of ipsilateral mediastinal lymph node metastasis (N2 disease) in non-small cell carcinoma of the lung. A commentary. J Thorac Cardiovasc Surg 1990;99:48-53.
1. Wilkins EW, Urschel HC. General Thoracic Surgery: History and Development. In: Pearson FG, Cooper JD, editors. Thoracic Surgery. Philadelphia: Churchill Livingstone; 2002. p. 1-8.