Kenan Can CEYLAN, Demet YALDIZ, Şeyda ÖRS KAYA

Pulmoner karsinoid tümörlerde nodal tutulum prognozu kötü etkiler

Amaç: Bu çalışmada pulmoner karsinoid tümörlerde sağkalımı etkileyen prognostik faktörler incelendi. Çalışma planı: 1 Ocak 2005 - 31 Aralık 2016 tarihleri arasında, pulmoner karsinoid tümör dolayısıyla rezeksiyon uygulanan olgularda cinsiyet, yaş, sigara kullanımı, eşlik eden hastalık, tümörün yerleşim yeri, T durumu, N durumu, histolojik tip ve patolojik evre geriye dönük olarak gözden geçirildi. Bulgular: Çalışmamıza 40 tipik ve 7 atipik karsinoid tümör olmak üzere 47 hasta (18 erkek, 29 kadın; ort yaş 50.5 yıl; dağılım, 23-74 yıl) dahil edildi. Tüm hastalara anatomik rezeksiyon ve sistematik mediastinal lenf nodül diseksiyonu uygulandı. Patolojik değerlendirmede altı hastada lenfatik tutulum saptandı (%12.8; 4 pN1 ve 2 pN2). Tipik grupta (n=40) üç hasta N1 (%7.5) ve bir hasta N2 (%2.5) olarak sınıflandırıldı. Atipik grupta (n=7) bir hasta N1 (14.3%) ve bir hasta N2 (14.3%) olarak sınıflandırıldı. Çalışma boyunca, tipik histolojisi olan dört (%10) ve atipik histolojisi olan iki (%28.6) hastada nodal tutulum vardı. Nodal tutulum olan altı hastanın tamamına adjuvan tedavi uygulandı. Atipik histoloji (p=0.005) ve nodal tutulum (p=0.008) istatistik çalışmada kötü prognostik faktör olarak saptandı. Sonuç: Pulmoner karsinoid tümörün cerrahi tedavisinde, sistematik hiler ve mediastinal lenf nodu diseksiyonunun önemli rolü vardır.

Nodal involvement adversely affects prognosis in pulmonary carcinoid tumors

Background: This study aims to analyze the prognostic factors affecting survival in pulmonary carcinoid tumors.Methods: Gender, age, smoking habit, comorbidity, localization of the tumor, T status, N status, histological type, and pathological stage of patients who had undergone resection of pulmonary carcinoid tumor between January 1, 2005 and December 31, 2016 were retrospectively reviewed.Results: A total of 47 patients (18 male, 29 female; mean age 50.5 years; range, 23 to 74 years) consisting of 40 typical and 7 atypical carcinoid tumor cases were included in our study. Anatomical resection and systematic mediastinal lymph node dissection was performed on all patients. Pathological studies revealed lymphatic involvement in six patients (12.8%; 4 pN1 and 2 pN2). In the typical group (n=40), three patients were classified N1 (7.5%) and one patient N2 (2.5%). In the atypical group (n=7), one patient were classified N1 (14.3%) and one patient N2 (14.3%). Throughout the study, four patients with typical histology (10%) and two patients with atypical histology (28.6%) had nodal involvement. All six patients with nodal involvement underwent adjuvant radiotherapy. Atypical histology (p=0.005) and nodal involvement (p=0.008) were determined as negative prognostic factors in statistical analysis.Conclusion: Systematic hilar and mediastinal nodal dissection play a crucial role in the surgical treatment of pulmonary carcinoid tumors.

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