Volkan BAYSUNGUR, Çağatay TEZEL, Talha DOĞRUYOL, Serda Metin KANBUR, Levent ALPAY, Hakan KIRAL, Hakan YILMAZ, Deniz GÜRER, Bora GÜRER

Senkron beyin metastazı bulunan akciğer kanserinde cerrahi rezeksiyon sonuçları

Amaç: Bu çalışmada senkron beyin metastazlı ameliyat edilmiş küçük hücreli dışı akciğer kanseri hastalarının sağkalımını etkileyen faktörler araştırıldı. Çalışma planı: Kliniğimizde Ocak 2012 ve Ocak 2016 tarihleri arasında küçük hücreli dışı akciğer kanseri ve eşlik eden tek/oligo beyin metastazı tanısı konulan ve primer olarak beyin için girişim yapılan, ardından akciğer rezeksiyonu uygulanan toplam 16 hastanın (14 erkek, 2 kadın; ort. yaş 60 yıl; dağılım, 41-71 yıl) klinik sonuçları retrospektif olarak incelendi. Beyin metastazlarının tedavisi için kraniyal cerrahi veya gamma-knife radyocerahisi uygulandı. Bulgular: Akciğer rezeksiyonu öncesi tek beyin metastazı olan 12 hastaya kraniyal cerrahi uygulanır iken tek/oligo metastazı olan dört hastaya gamma-knife radyocerrahisi uygulandı. Nihai patolojik inceleme 13 hastada adenokarsinom ve üç hastada akciğerin skuamöz hücreli karsinomu olduğunu gösterdi. Ortalama sağkalım süresi 15.3±8.6 ay idi. Bir ve iki yıllık sağkalım oranları sırasıyla %56.2 ve %32 idi. Beyin metastazlarının sayısı, tedavi tipi, tümör hücre tipi, rezeksiyon tipi ve lenf nodlarının durumu sağkalımla istatistiksel olarak anlamlı şekilde ilişkili değildi (p>0.05). Sonuç: Senkron beyin metastazlı seçilmiş küçük hücreli dışı akciğer kanseri hastalarında kraniyal cerrahi veya gamma-knife radyocerrahisi sonrası agresif akciğer rezeksiyonu etkili bir şekilde uygulanabilir. Ancak primer tümörün ve beyin metastazlarının tam rezeksiyon için uygunluğu hasta seçiminde son derece önem arz etmektedir.

Results of surgical resection in lung cancer with synchronous brain metastasis

Background: This study aims to investigate the factors affectingthe survival of operated non-small cell lung cancer patients withsynchronous brain metastasis.Methods: Clinical outcomes of a total of 16 patients (14 males,2 females; mean age 60 years; range, 41 to 71 years) whowere diagnosed with non-small cell lung cancer and concomitantsolitary/oligo brain metastasis and who underwent an interventionprimarily for cranium, followed by lung resection in our clinicbetween January 2012 and January 2016 were retrospectivelyanalyzed. Cranial surgery or gamma-knife radiosurgery wasperformed in the treatment of brain metastases.Results: Twelve patients with solitary brain metastasis underwentcranial surgery, while four patients with solitary/oligo metastasesunderwent gamma-knife radiosurgery prior to pulmonary resection.Definitive pathological examination revealed adenocarcinoma in13 patients and squamous-cell lung carcinoma in three patients.Mean survival time was 15.3±8.6 months. One-year and two-yearsurvival rates were 56.2% and 32%, respectively. The number ofbrain metastases, treatment type, tumor cell type, resection type,and status of lymph nodes were not statistically significantlyassociated with survival (p>0.05).Conclusion: Cranial surgery or gamma-knife radiosurgeryfollowed by aggressive lung resection can be effectively appliedin selected non-small cell lung cancer patients with synchronousbrain metastasis. However, the suitability of the primary tumor andbrain metastases for complete resection is of utmost importance inpatient selection.

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