TY  - JOUR
T1  - Akciğerin büyük hücreli nöroendokrin karsinomundaki cerrahi sonuçlarımız
TT  - Surgical outcomes of large cell neuroendocrine carcinoma of the lung
AU  - Yanık, Fazlı
AU  - Karamustafaoğlu, Yekta Altemur
AU  - Yoruk, Yener
PY  - 2019
DA  - December
DO  - 10.18663/tjcl.479216
JF  - Turkish Journal of Clinics and Laboratory
JO  - TJCL
PB  - DNT Ortadoğu Yayıncılık A.Ş.
WT  - DergiPark
SN  - 2149-8296
SP  - 474
EP  - 478
VL  - 10
IS  - 4
LA  - tr
AB  - Giriş/Amaç: Akciğerin büyük hücrelinöroendokrin karsinomları (BHNK) yüksek dereceli nadir tümörlerdir ve küçük hücreli akciğer kanserinebenzer klinik ve biyolojik özellikler taşırlar. Bu çalışmada histopatolojiktanısı akciğerin BHNK’u olan olgulardaki cerrahi sonuçlarımızı, prognozu vesağkalımı irdeledik. Materyal-Metod:Haziran 2012-Haziran2018 tarihleri arasında rezeksiyon yapılan ve patolojik tanıları BHNK olarakraporlanan biri kadın, 11’i erkek, ortalama yaşları 61,4±7,5(48-74 yaş) olan 12olgu retrospektif olarak değerlendirildi. Prognoz, yaş, cins, sigara içmehikayesi, tümör çapı, tanı tedavi modaliteleri, cerrahi sonuçlar ve sağkalımhastane kayıtlarından analiz edildi.Bulgular:Sekiz olguda tümörsağ hemitoraks yerleşimli iken, dört olguda sol hemitoraks yerleşimliydi. 11olguda mediastinoskopi ve anatomik akciğer rezeksiyonu ile mediastinal lenfnodu diseksiyonu uygulandı. T1 evreli bir olgu ise bilgisayarlı torakstomografisinde mediastende patolojik lenf nodu olmadığı için, mediastinoskopiyapılmadan, video yardımlı lobektomi ve mediastinal lenf nodu diseksiyonuuygulandı. Olguların yedisi (%58) takipler sırasında metastaz veya tümör progresyonunedeniyle kaybedildi. Ortalama tümör çapı, ortalama sağ-kalım süresi,hastalıksız sağ-kalım süresi ve ortalama hastanede kalış süresi sırasıyla;4,4±2,1 cm (dağılım 1-8 cm), 17,9±19,04 ay (dağılım 2-72 ay), 15,08±19,6 ay (dağılım 1-72 ay ) ve 6,4±3,6 gün (4-12 gün) olarak hesaplandı. Postoperatifmortalite görülmedi. İki(%16) olguda komplikasyon (atelektazi ve yara yerienfeksiyonu) görüldü.Sonuç:Tedavi ve sağ-kalımaçısından küçük hücreli akciğer kanserine benzer özellikler taşısa da, tedavistratejisinde tam olarak bir fikir birliğinin sağlanamamıştır. Günümüzde küratifanatomik rezeksiyonlar ve beraberinde eklenecek onkolojik tedaviler uzun dönemsağ-kalım için tek şans gibi gözükmektedir. Ancak bu nadir görülen tümörlerleilgili daha geniş vaka serilerini içeren çalışmalara ihtiyaç vardır.
KW  - akciğer
KW  - tümör
KW  - nöroendokrin
N2  - Aim:‘Large cell neuroendocrine carcinoma of the lung’ (LCNECL) is high-grade raretumors and has clinical and biological characteristics similar to small celllung cancer. In this study, we evaluated the surgical results, prognosis andsurvival of the patients with histopathologically LCNECL.Materials and Methods: Twelvepatients, one female and 11 male, with amean age of 61,4±7,5(48-74 years), who were reported as LCNECL between June2012 and June 2018 was performed resection, were evaluated retrospectively.Prognosis, age, sex, smoking history, tumor size, diagnostic treatmentmodalities, surgical outcomes and survival was analyzed from hospital records.Results: Whilein eight cases the tumor was located in the right hemithorax, in four cases wasleft hemithorax. Mediastinoscopy and anatomic lung resection with mediastinallymph node dissection were performed in 11 cases. In one case with T1 stage,video-assisted lobectomy and mediastinal lymph node dissection were performedwithout mediastinoscopy because there was no pathological lymph node in the mediastinumin chest computerized tomography. Seven patients (58%) died due to tumorprogression or metastasis during follow-up. The median tumor size, mediansurvival time, median disease-free survival time and median lenght of hospitaltime were 4.4±2.1cm (range1-8cm),17.9±19.04months(range2-72months), 15,08±19.6months(range1-72months) and6,4±3,6days(4-12days), respectively. There was no postoperative mortality.Two(16%) patients with complications (atelectasis and wound infection) wereobserved.Conclusion: Althoughthey have similar features with small cell lung cancer in terms of treatmentand survival rates, no consensus have been identified in their treatmentstrategy. Today, curative anatomic resections and accompanying oncologicaltherapies seem to be the only chance for long-term survival. However, there isa need for studies including larger case series about these rare tumors
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UR  - https://doi.org/10.18663/tjcl.479216
L1  - https://dergipark.org.tr/tr/download/article-file/913381
ER  -