KÜÇÜK HÜCRELİ DIŞI AKCİĞER KANSERİNİN SOLİTER ORGAN METASTAZLARINDA CERRAHİ YAKLAŞIM: SAĞKALIM UZATILABİLİR Mİ?

Yıl 2007, Cilt: 21 Sayı: 3, 53 - 58, 01.12.2007

Alpaslan Çakan

Öz

Küçük hücreli dışı akciğer kanserli olgularda, senkron ya da metakron metastazlar M1 (Evre IV) olarak değerlendirilmektedir. Metastazektomi konusundaki en fazla deneyim ve başarı, beyin ve sürrenaldeki soliter metastazların cerrahi tedavisinde elde edilmiştir. Bu olgular dışındakiler genellikle inoperabl kabul edilmekte, uygulanan kemoterapi ve/veya radyoterapiye rağmen oldukça kısa bir sağkalım beklentisi bulunmaktadır. Ancak günümüzde, diğer organların soliter metastazlarında da cerrahi uygulamalarına başlanmıştır.

Anahtar Kelimeler

Akciğer kanseri, soliter metastaz, rezeksiyon, sağkalım

SURGICAL RESECTION FOR SOLITARY METASTASES IN NON-SMALL CELL LUNG CANCER: CAN SURVIVAL BE PROLONGED?

Öz

In non-s mall cell lung cancer patients, synchronous or metachronous metastases classified as M1 (stage IV) disease. Most experiences and success about metastatectomy are obtained from surgical treatment of solitary metastases of brain and adrenal glands. Except these cases, all are accepted as inoperable, and long term survival is not achieved despite chemotherapy and/or irradiation in most cases. However, surgical intervention constitutes a hopeful approach for solitary metastases of other organs in lung cancer recently.

Anahtar Kelimeler

Lung cancer, solitary metastasis, resection, survival

Kaynakça

• 1. Ponn RB, LoCicero III J, Daly BDT. Surgical treatment of non-small cell lung cancer. In: Shields TW, LoCicero III J, Ponn RB, Rusch VW (eds). General Thoracic Surgery. Philadelphia: Lippincott Williams and Wilkins; 2005: 1548-87.
• 2. Han S. Küçük hücreli d›fl› akci¤er kanserlerinde cerrahi sonuçlar. Ökten ‹, Güngör A (eds). Gö¤üs Cerrahisi. Ankara: Sim Matbaac›l›k; 2003: 1099-110.
• 3. Gürses A, Metin M. Küçük hücreli d›fl› akci¤er karsinomunda metastatik hastal›k. Yüksel M, Kalayc› NG (eds). Gö¤üs Cerrahisi. ‹stanbul: Bilmedya Grup; 2001: 359-62.
• 4. Kagohashi K, Satoh H, Ishikawa H, Ohtsuka M, Sekizawa K. Liver metastasis at the time of initial diagnosis of lung cancer. Med Oncol 2003; 20: 25-8.
• 5. Di Carlo I, Grasso G, Patane D, Russello D, Latteri F. Liver metastases from lung cancer: is surgical resection justified? Ann Thorac Surg 2003; 76: 291-3.
• 6. Nagashima A, Abe Y, Yamada S, Nakagawa M, Yoshimatsu T. Long-term survival after surgical resection of liver metastasis from lung cancer. Jpn J Thorac Cardiovasc Surg 2004; 52: 311-3.
• 7. Romano F, Porta A, Caprotti R, Uggeri F, Conti M, Uggeri F. Cystic liver metastases from lung adenocarcinoma: a case report. Tumori 2004; 90: 525-7.
• 8. Kinoshita A, Nakano M, Fukuda M, Kasai T, Suyama N, Inoue K, Nakata T, Shigematsu K, Oka M, Hara K. Splenic metastasis from lung cancer. Neth J Med 1995; 47: 219-23.
• 9. Schmidt BJ, Smith SL. Isolated splenic metastasis from primary lung adenocarcinoma. South Med J 2004; 97: 298-300.
• 10. Tomaszewski D, Bereza S, Sternau A. Solitary splenic metastases from lung cancer: one time surgical procedure. Pneumonol Alergol Pol 2003; 71: 533-7.
• 11. fianl› A, Önen A, Karaçam V, Öztop ‹, Gökçen B, Hayretda¤ A, Aç›kel Ü. Isolated solitary splenic metastasis of a pulmonary tumor: a successful surgical approach in one stage. Türk Gö¤üs Kalp Damar Cer Derg 2006; 14: 73-5.
• 12. Sarela AI, Murphy I, Coit DG, Conlon KC. Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol 2003; 10: 1191-6.
• 13. Kim SH, Brennan MF, Russo P, Burt ME, Coit DG. The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998; 82: 389-94.
• 14. Luketich JD, Burt ME. Does resection of adrenal metastases from non-small cell lung cancer improve survival? Ann Thorac Surg 1996; 62: 1614-6.
• 15. Porte H, Siat J, Guibert B, Lepimpec-Barthes F, Jancovici R, Bernard A, Foucart A, Wurtz A. Resection of adrenal metastases from non-small cell lung cancer: a multicenter study. Ann Thorac Surg 2001; 71: 981-5.
• 16. Pfannschmidt J, Schlolaut B, Muley T, Hoffmann H, Dienemann H. Adrenalectomy for solitary adrenal metastases from nonsmall cell lung cancer. Lung Cancer 2005; 49: 203-7.
• 17. Mercier O, Fadel E, de Perrot M, Mussot S, Stella F, Chapelier A, Dartevelle P. Surgical treatment of solitary adrenal metastasis from no n-small cell lung cancer. J Thorac Cardiovasc Surg 2005; 130: 136-40.
• 18. Luketich JD, Martini N, Ginsberg RJ, Rigberg D, Burt ME. Successful treatment of solitary extracranial metastases from non-small cell lung cancer. Ann Thorac Surg 1995; 60: 1609-11.
• 19. Hirose M, Ota S, Ishibashi H. Surgical indication for non-small cell lung cancer with synchronous distant metastases. Kyobu Geka 2006; 59: 15-20.
• 20. Billing PS, Miller DL, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac Cardiovasc Surg 2001; 122: 548-53.
• 21. Saitoh Y, Fujisawa T, Shiba M, Yoshida S, Sekine Y, Baba M, Iizasa T, Kubota M. Prognostic factors in surgical treatment of solitary brain metastasis after resection of non-small cell lung cancer. Lung Cancer 1999; 24: 99-106.
• 22. Wronski M, Arbit E, Burt M, Galicich JH. Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991. J Neurosurg 1995; 83: 605-16.
• 23. Furak J, Trojan I, Szoke T, Agocs L, Csekeo A, Kas J, Svastics E, Eller J, Tiszlavicz L. Lung cancer and its operable brain metastasis: survival rate and staging problems. Ann Thorac Surg 2005; 79: 241-7.