PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE

Berker Özkan; Erkan Kaba; Suat Erus; Murat Kapdağlı; Sedat Ziyade; Serhan Tanju; Adalet Demir; Şükrü Dilege; Alper Toker

doi:10.18017/iuitfd.60951

PRİMER AKCİĞER KANSERİNDE NEOADJUVAN TEDAVİ UYGULANMIŞ HASTALARDA AKCİĞER REZEKSİYONLARI: İLK 90 OLGUNUN GÜNCEL BİLGİLERİMİZLE GÖZDEN GEÇİRİLMESİ

Year 2016, , 1 - 8, 09.02.2016

Berker Özkan , Erkan Kaba , Suat Erus Murat Kapdağlı Sedat Ziyade Serhan Tanju Adalet Demir Şükrü Dilege Alper Toker

https://doi.org/10.18017/iuitfd.60951

Abstract

Amaç: Bu çalışmanın amacı neoadjuvan kemoterapi ve kemoradyoterapi sonrası cerrahi tedavi uygulanan primer akciğer tümörlü hastaların nüks, sağkalım, komplikasyon, morbidite ve mortalite açısından incelenmesidir.

Gereç ve Yöntem: Haziran 2001-Aralık 2008 tarihleri arasında 59’u neoadjuvan kemoterapi, 31’i ise neoadjuvan kemoradyoterapi sonrası opere edilen toplam 90 hasta retrospektif olarak 3 gruba ayrılarak incelendi: 47 klinik T3/N2, 23 T4(N0-1), 20 histopatolojik olarak pozitif N2 (T1-3) hasta mevcuttu. Olguların yaşları, cinsiyetleri, tümör patolojileri, rezeksiyon tipleri, komplikasyonları, mortalite ve sağkalım oranları incelendi.

Bulgular: Hastaların 76’sı erkek, 14’ü kadındı. Yaş ortalaması 55.3±8.5 (36-75) idi. Olguların 36’sına lobektomi, 11’ine lobektomiyle birlikte genişletilmiş rezeksiyon, 13’üne sleeve lobektomi, 30’una pnömonektomi uygulandı. Tüm olguların major komplikasyon oranı %14.4, mortalite %2.2 idi. Minimal takip süresi 24 ay, ortalama takip süresi ise 27±18 aydı. Ortalama sağkalım oranı 25±4.6 ay; (patolojik evre I:35±9.7 ay, evre II:33±8.5 ay, evre IIIa:24±9.7 ay ve evre IIIb:14±10.9 ay) olarak hesaplandı. Ortalama sağkalım klinik T3/N2 grubunda 26±6.7 ay, T4 grubunda 14±2.2 ay ve histopatolojik N2 grubunda 41±3.7 aydı. Klinik T3/N2 grubu ile histopatolojik N2 grubunun sağkalım süreleri arasında istatistiksel olarak anlamlı fark saptandı (p<0.05).

Sonuç: Çalışmamızda neoadjuvan tedavi sonrası akciğer rezeksiyonlarının kabul edilebilir komplikasyon, morbidite-mortalite oranlarıyla uygulanabileceği görülmüştür. Mediastinal lenf nodlarının tam ve doğru evrelendiği olgularda önemli oranda sağkalım avantajı sağladığı saptanmıştır.

Anahtar kelimeler: Akciğer kanseri; göğüs cerrahisi; neoadjuvan tedavi sonrası cerrahi

PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE

Year 2016, , 1 - 8, 09.02.2016

Berker Özkan , Erkan Kaba , Suat Erus Murat Kapdağlı Sedat Ziyade Serhan Tanju Adalet Demir Şükrü Dilege Alper Toker

https://doi.org/10.18017/iuitfd.60951

Abstract

Objective: In this study, we aimed to analyse the non-small cell
lung carcinoma patients who have undergone surgery after neoadjuvant
chemo/chemoradiotherapy in regards
to recurrences, survival, complication, morbidity, and mortality.

Materials and Methods: The data of 90 patients who had surgeries between June
2001 and December 2008 were retropectively evaluated. Fifty nine of those 90
patients had neoadjuvant chemotherapy and 31 patients had neoadjuvant
chemoradiotherapy. Patients were divided into 3 groups; 47 patients were
clinical T3/N2, 23 patients were clinical T4(N0-1), 20 patients were
histopatologically proven N2(T1-3). Age, gender, tumor pathology, resection
type, complications, mortality and survival rates of the patients were
evaluated.

Results: There were 76 male, 14 female patients in our study
group. Mean age was 55.3±8.5 (36-75) years. Thirty six patients had lobectomy,
11 patients had extended resections with lobectomy, 13 patients had sleeve
lobectomy, and 30 patients had pneumonectomy operations. Major complication and
mortality rates were 14.4% and 2.2% respectively. Minimal and mean follow-up
periods were 24 and 27±18 months
respectively. Mean survival was calculated as 25±4.6 months (pathological stage
I: 35±9.7 months, stage II: 33±8.5 months, stage IIIa: 24±9.7 months, and stage
IIIb: 14±10.9 months). Mean survival was 26±6.7 months in clinical T3/N2 group,
14±2.2 months in T4 group, 41±3.7 months in histopathological N2 group. There
was a statisticaly significant difference in survival times between clinical
T3/N2 and histopathological N2 groups (p<0.05).

Conclusion: Lung resections after neoadjuvant therapy can be
achieved with acceptable rates of complications, morbidity, and mortality.
Surgery in selected patients with proper mediastinal staging may also provide
longer survival.

Keywords

Lung cancer, thoracic surgery, surgery after neoadjuvant treatment

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Details

Subjects	Health Care Administration
Journal Section	Clinical Research
Authors	Berker Özkan Erkan Kaba Suat Erus This is me Murat Kapdağlı This is me Sedat Ziyade This is me Serhan Tanju This is me Adalet Demir This is me Şükrü Dilege This is me Alper Toker This is me
Publication Date	February 9, 2016
Submission Date	October 29, 2015
Published in Issue	Year 2016

Cite

APA	Özkan, B., Kaba, E., Erus, S., Kapdağlı, M., et al. (2016). PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE. Journal of Istanbul Faculty of Medicine, 79(1), 1-8. https://doi.org/10.18017/iuitfd.60951
AMA	Özkan B, Kaba E, Erus S, Kapdağlı M, Ziyade S, Tanju S, Demir A, Dilege Ş, Toker A. PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE. İst Tıp Fak Derg. April 2016;79(1):1-8. doi:10.18017/iuitfd.60951
Chicago	Özkan, Berker, Erkan Kaba, Suat Erus, Murat Kapdağlı, Sedat Ziyade, Serhan Tanju, Adalet Demir, Şükrü Dilege, and Alper Toker. “PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE”. Journal of Istanbul Faculty of Medicine 79, no. 1 (April 2016): 1-8. https://doi.org/10.18017/iuitfd.60951.
EndNote	Özkan B, Kaba E, Erus S, Kapdağlı M, Ziyade S, Tanju S, Demir A, Dilege Ş, Toker A (April 1, 2016) PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE. Journal of Istanbul Faculty of Medicine 79 1 1–8.
IEEE	B. Özkan, E. Kaba, S. Erus, M. Kapdağlı, S. Ziyade, S. Tanju, A. Demir, Ş. Dilege, and A. Toker, “PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE”, İst Tıp Fak Derg, vol. 79, no. 1, pp. 1–8, 2016, doi: 10.18017/iuitfd.60951.
ISNAD	Özkan, Berker et al. “PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE”. Journal of Istanbul Faculty of Medicine 79/1 (April 2016), 1-8. https://doi.org/10.18017/iuitfd.60951.
JAMA	Özkan B, Kaba E, Erus S, Kapdağlı M, Ziyade S, Tanju S, Demir A, Dilege Ş, Toker A. PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE. İst Tıp Fak Derg. 2016;79:1–8.
MLA	Özkan, Berker et al. “PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE”. Journal of Istanbul Faculty of Medicine, vol. 79, no. 1, 2016, pp. 1-8, doi:10.18017/iuitfd.60951.
Vancouver	Özkan B, Kaba E, Erus S, Kapdağlı M, Ziyade S, Tanju S, Demir A, Dilege Ş, Toker A. PULMONARY RESECTIONS AFTER NEOADJUVANT THERAPY IN PATIENTS WITH PRIMARY LUNG CARCINOMA: RE-EVALUATION OF THE FIRST 90 PATIENTS WITH RECENT EXPERIENCE. İst Tıp Fak Derg. 2016;79(1):1-8.