Soner GÜRSOY, Onur AKÇAY, Ozan USLUER, Özgür SAMANCILAR, Şeyda Örs KAYA, Suat Seren Chest DİSEASES

The effect of the number of dissected lymph nodes on survival in patients operated on for T1a-T2a N0 non-small cell lung cancer

Bu çalışmada T1a-T2a N0 küçük hücreli dışı akciğer kanseri nedeni ile ameliyat edilmiş hastalarda diseke edilen lenf nodu sayısının sağkalım üzerine etkisi araştırıldı.Çalışma planı: Ocak 2005 ve Aralık 2009 tarihleri arasında küçük hücreli dışı akciğer kanseri nedeni ile ameliyat edilmiş hastaların tıbbi kayıtları ve izlem verileri retrospektif olarak incelendi. Neoadjuvan tedavi almamış, patolojik evresi T1aN0M0, T1bN0M0ve T2aN0M0 (malign tümörlerin tümör-nodül-metastaz sınıflandırmasının yedinci edisyonuna göre evre I) olan, lobektomi veya pnömonektomi ile mediastinal lenf nodu diseksiyonu uygulanmış 141 hasta (128 males, 13 females; mean age 63±8.7 years; range 37 to 82 years) çalışmaya dahil edildi. N1 ve N2 istasyonlarından diseke edilen lenf nodlarının toplam sayısı ile hastaların sağkalımları arasında ilişkinin anlamlı olup olmadığı değerlendirildi. Hastalar iki gruba ayrıldı: Grup A diseke edilen lenf nodu sayısı dokuzdan az olan hastaları içerir iken grup B diseke edilen lenf nodu sayısı dokuz ve dokuzdan fazla olan hastaları içeriyor idi. Her iki grubun sağkalım oranları karşılaştırıldı.Bul gu lar: Sağkalım oranı grup B ile kıyaslandığında grup A'da daha düşük idi ve bu fark istatistiksel olarak anlamlı idi. Çok değişkenli Cox regresyon analizi, diseke edilen lenf nodu sayısının bağımsız bir prognostik faktör olduğunu (yaş, cinsiyet, T evresi, rezeksiyon tipi ve histopatolojik alt tipe ek olarak) ortaya koydu.So nuç: Küçük hücreli dışı akciğer kanserinde evresi T1a-T2a N0olan hastalarda diseke edilen lenf nodu sayısı sağkalımı etkiler. Cerrahlar akciğer kanseri cerrahisinde mümkün olduğunca çok sayıda lenf nodunu diseke etmeye çalışmalıdılar

T1a-T2a N0 küçük hücreli dışı akciğer kanseri nedeni ile ameliyat edilmiş hastalarda diseke edilen lenf nodu sayısının sağkalım üzerine etkisi

This study aims to investigate the effect of the number of dissected lymph nodes on survival in patients operated on for T1a-T2aMethods: The medical records and follow-up data of patients operated on for non-small cell lung cancer between January 2005 and December 2009 were analyzed retrospectively. One hundred and forty-one patients (128 males, 13 females; mean age 63±8.7 years; range 37 to 82 years) who did not receive neoadjuvant treatment, with pathological stage of T1aN0M0, T1bN0M0, and T2aN0M0 (stage I according to seventh edition of tumor-node-metastasis classification of malignant tumors), and who were performed lobectomy or pneumonectomy and mediastinal lymph node dissection were included in this study. The significance between the total number of dissected lymph nodes from both N and N2 stations and the survival of the patients were evaluated. The patients were divided into two groups: Group A included the patients having less than nine lymph nodes dissected, whereas group B included the patients with nine or more dissected nodes. Survival rates of the two groups were compared.Results: The survival rate was lower in group A compared to that of group B and the difference was statistically significant. The multivariate Cox regression analysis demonstrated that the number of dissected lymph nodes (in addition to age, gender, T stage, type of resection, and histopathologic subtype) was an independent prognostic factor.Conclusion: The number of lymph nodes dissected effects survival in non-small cell lung cancer in patients with stage T-T2 N0. Surgeons should make an effort to dissect as many lymph nodes as possible during lung cancer surgery

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