The Effects of Metastasectomy on Survıval In Secondary Pulmonary Neoplasms

Yıl 2020, Cilt: 15 Sayı: 2, 7 - 13, 08.07.2020

Fatoş Kozanlı , Sami Karapolat , Atila Türkyılmaz , Celal Tekinbaş

https://doi.org/10.17517/ksutfd.669744

Öz

Objective: Secondary pulmonary neoplasms operated in our clinic were evaluated. The effect of pulmonary metastasectomy on survival was investigated.

 

Material and Methods:  In this study, between January 2010 and January 2015 in our clinic 29
cases operated for secondary pulmonary neoplasm were evaluated retrospectively.
Cases were individually analysed according to their demographics. Our analysis
criteria were age, gender, histopathological type of primary tumor, stage of
secondary tumor and its preoperative radiological signs, length of life without
illness, types of surgical incision and resection, numbers of
complete-incomplete resections, number of pre/postoperative nodules,
cardiopulmonary evaluations and length of survival.

Results: 20 (69%) and 9
(31%) of our cases were male and female; respectively. Youngest case was 18
years old whereas oldest case was 75 years old. Mean age of cases was 56±12
years. Number of our cases was 29 and they had undergone 38 surgical
intervention.

 Most common surgical intervention was
posterolateral thoracotomy (PLT) in 24 cases. Secondary most common surgical
intervention was Video Assisted Thoracoscopic Surgery (VATS) in 14 cases.

 In terms of histopathological type of primary
tumor, most common types were carcinoma (79.3%) and sarcoma (17.2%). 5-year
survival rate in pulmonary metastasectomy was 40% in sarcomas and 73.5% in
carcinomas. It was observed that pulmonary metastasectomy was more beneficial
in carcinomas than sarcomas.

Conclision: In conclusion, metastasectomy significantly improves
survival in secondary pulmonary neoplasm cases whose primary malignancy is
under control without metastasis in any other extrapulmonary area. Stage of
secondary tumor and histopathological type of primary tumor were observed as
actual factors determining survival.

Anahtar Kelimeler

Secondary pulmonary neoplasm, metastasectomy, survival

Sekonder Akciğer Neoplazmlarında Metastazektominin Sağkalım Üzerine Olan Etkisi

Öz

Amaç: Kliniğimizde opere edilen sekonder akciğer neoplazmları incelenerek, primer tümör kontrol altında ikenyapılan metaztazektominin sağkalım üzerine olan etkilerinin araştırılması.
Materyal metod: Bu çalışmada Ocak 2010 ile Ocak 2015 yılları arasında kliniğimizde sekonder pulmoner neoplazm nedeni ile opere edilen 29 olgu retrospektif olarak incelendi. Olgular yaş, cinsiyet, kardiopulmoner değerlendirmeler, primer tümörün histopatolojik tipi, sekonder tümörün evresi ve preoperatif radyolojik bulguları, hastalıksız yaşam süreleri, cerrahi insizyon şekilleri ve rezeksiyonun türü, komplet-inkomplet rezeksiyon sayıları, nodül sayıları, sağkalım süreleri açısından değerlendirildi.
Bulgular: Olguların 9’u kadın (%31) 20’si (%69) erkek idi. En küçük yaş 18 en büyük yaş 75 (ortalama 56±12) idi.
Olgularımıza toplam 38 cerrahi girişim uygulandı. En sık uygulanan cerrahi girişim 24 olguda (%63,2) posterolateral torakotomi (PLT), 14 olguda (%36,8) video yardımlı torakoskopik cerrahi (VATS) idi. Bir yıllık sağkalım %96, 3 yıllık sağkalım %72 ve 5 yıllık sağkalım % 58 olarak bulundu. Primer tümörün histopatolojik tipine göre en sık karsinom (%79,3) ikinci sıklıkta sarkom (%17,2) tespit edildi.Sarkomlarda pulmoner metastazektominin 5 yıllık sağkalım %40, karsinomlarda %73,5 olarak hesaplandı.
Sonuç: Primer malignitesi kontrol altında ve ekstra pulmoner metastazı olmayan sekonder pulmoner neoplazmlı olgularda, metastazektomi, özellikle karsinomlarda sağkalıma önemli ölçüde katkı sağlanmaktadır. Çalışmamızda sekonder tümörün evresinin ve primer tümörün histopatolojik tipinin sağkalımı belirleyen esas faktörler olduğu görüldü.

Anahtar Kelimeler

akciğer neoplazm, metastazektomi, sağkalım

Kaynakça

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