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Evaluation of the effect of intraoperative frozen section on overall timeliness and survival in lung cancer surgery

Yıl 2023, , 891 - 895, 30.09.2023
https://doi.org/10.16899/jcm.1347963

Öz

Background/Aim: We aimed to find out whether there is any delay in the management of the process in patients operated on for lung cancer and to understand the effect of intraoperative frozen section on this process.

Methods: 176 patients were analyzed in total. The dates of admission, diagnosis, operation, and postoperative pathology results were noted. Five intervals were defined as time from first evaluation to diagnosis, first evaluation to surgery, diagnosis to surgery, first evaluation to the day of the postoperative pathology report, and diagnosis to the day of the postoperative pathology report.

Results: The majority of patients (81.8%) were male, and the median age was 63 years (iqr = 11). The median time between the first assessment and the final pathological examination result was 62 days (iqr = 70). The time from initial presentation to surgery was significantly shorter (p 0.001), and the time from diagnosis to final pathology was also significantly shorter (p 0.001) in patients diagnosed by frozen section. However, there was no significant difference in the time from initial evaluation to diagnosis between the two groups (0.052). There was no significant difference in survival between patients diagnosed by freezing and patients diagnosed by other methods (p = 0.508).

Conclusion: Solutions to increase the timeliness of care for patients with lung cancer can be designed with a better understanding of delays. Intraoperative frozen section diagnosis improves overall timeliness but has no effect on survival in lung cancer patients undergoing surgery.

Destekleyen Kurum

no support

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
  • 2. 2018 Kanser İstatistikleri, T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Kanser Dairesi Başkanlığı. https://hsgm.saglik.gov.tr/tr/kanser-istatistikleri, posted to the website, 2022
  • 3. Nooreldeen R, Bach H. Current and Future Development in Lung Cancer Diagnosis. Int J Mol Sci. 2021 Aug 12;22(16):8661.
  • 4. Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106(7):1262-1267.
  • 5. Villalba JA, Shih AR, Sayo T, et al. Accuracy and reproducibility of intraoperative assessment on tumor spread through air spaces in stage 1 lung adenocarcinomas. J Thorac Oncol. 2021;16(4):619–629.
  • 6. Fan J, Yao J, Si H, Xie H, Ge T, Ye W, Chen J, Yin Z, Zhuang F, Xu L, Su H, Zhao S, Xie X, Zhao D, Wu C, Zhu Y, Ren Y, Xu N, Chen C; Surgical Thoracic Alliance of Rising Star Group. Frozen sections accurately predict the IASLC proposed grading system and prognosis in patients with invasive lung adenocarcinomas. Lung Cancer. 2023 Apr;178:123-130.
  • 7. Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106(7):1262-1267.
  • 8. Khorana AA, Tullio K, Elson P, Pennell NA, Grobmyer SR, Kalady MF, Raymond D, Abraham J, Klein EA, Walsh RM, Monteleone EE, Wei W, Hobbs B, Bolwell BJ. Time to initial cancer treatment in the United States and association with survival over time: An observational study. PLoS One. 2019 Mar 1;14(3):e0213209.
  • 9. Rao SS, Saha S. Timeliness of lung cancer diagnosis and treatment: a single-center experience. Asian Cardiovasc Thorac Ann. 2019;27(8):670-676.
  • 10. Schultz EM, Powell AA, McMillan A, et al. Hospital characteristics associated with timeliness of care in veterans with lung cancer. Am J Respir Crit Care Med2009;179: 595–600.
  • 11. Yorio JT, Xie Y, Yan J and Gerber DE. Lung cancerdiagnostic and treatment intervals in the United States: ahealth care disparity?J Thorac Oncol2009; 4: 1322–1330.17.
  • 12. Schultz EM, Powell AA, McMillan A, et al. Hospitalcharacteristics associated with timeliness of care in veter-ans with lung cancer.Am J Respir Crit Care Med2009;179: 595–600.18.
  • 13. Olsson JK, Schultz EM and Gould MK. Timeliness of care in patients with lung cancer: a systematic review.Thorax2009; 64: 749–756.
  • 14. Vidaver RM, Shershneva MB, Hetzel SJ, Holden TR andCampbell TC. Typical time to treatment of patients withlung cancer in a multisite, US-based study.J Oncol Pract2016; 12: e643–e653.
  • 15. Alberts WM, Bepler G, Hazelton T, Ruckdeschel JC andWilliams JH Jr; American College of Chest Physicians.Practice organization.Chest2003; 123: 332S–337S

Akciğer kanseri cerrahisinde intraoperatif frozen section uygulamasının genel zamanlama ve sağkalım üzerine etkisinin değerlendirilmesi

Yıl 2023, , 891 - 895, 30.09.2023
https://doi.org/10.16899/jcm.1347963

Öz

Amaç: Akciğer kanseri nedeniyle ameliyat edilen hastalarda sürecin yönetiminde herhangi bir gecikme olup olmadığını bulmayı ve intraoperatif frozen incelemenin bu süreçteki etkisini anlamayı hedefledik.

Gereç ve Yöntem: Toplam 176 hasta analiz edildi. Başvuru tarihleri, tanıları, yapılan ameliyatlar ve ameliyat sonrası patoloji sonuçları kaydedildi. İlk başvurudan histopatolojik tanının konulmasına, cerrahi gününe ve ameliyat sonrası patolojinin sonuçlandığı güne kadar olan 3 zaman dilimi, histopatolojik tanının konulduğu günden cerrahiye kadar olan interval ve cerrahi gününden ameliyat sonrası patolojinin sonuçlandığı güne kadar olan gün olmak üzere toplam 5 interval tanımlandı.

Bulgular: Hastaların çoğunluğu (%81,8) erkekti ve ortanca yaş 63 (IQR=11) idi. İlk değerlendirmeden nihai patolojik inceleme sonucuna kadar geçen ortanca süre 62 gündü (iqr=70). İntraoperatif frozen inceleme ile tanı konulan hastalarda ilk başvurudan ameliyata kadar geçen süre anlamlı olarak daha kısaydı (p<0.001) ve tanıdan nihai patolojiye kadar geçen süre de anlamlı olarak daha kısaydı (p<0.001). Ancak, ilk değerlendirmeden tanıya kadar geçen süre açısından iki grup arasında anlamlı bir fark yoktu (0,052). İntraoperatif frozen ile tanı konulan hastalar ile preoperatif diğer yöntemlerle tanı konulan hastalar arasında sağkalım açısından anlamlı bir fark bulunmadı (p=0,508).

Sonuç: Akciğer kanserli hastaların bakımının zamanında yapılmasını sağlayacak planlar ancak gecikmelerin daha iyi anlaşılmasıyla tasarlanabilir. Akciğer kanseri nedeniyle cerrahi uygulanan hastalarda tanının intraoperatif frozen inceleme ile koyulması tüm sürecin hızlanmasına katkı sağlar ancak sağkalım üzerinde bir etkisi yoktur.

Kaynakça

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
  • 2. 2018 Kanser İstatistikleri, T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Kanser Dairesi Başkanlığı. https://hsgm.saglik.gov.tr/tr/kanser-istatistikleri, posted to the website, 2022
  • 3. Nooreldeen R, Bach H. Current and Future Development in Lung Cancer Diagnosis. Int J Mol Sci. 2021 Aug 12;22(16):8661.
  • 4. Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106(7):1262-1267.
  • 5. Villalba JA, Shih AR, Sayo T, et al. Accuracy and reproducibility of intraoperative assessment on tumor spread through air spaces in stage 1 lung adenocarcinomas. J Thorac Oncol. 2021;16(4):619–629.
  • 6. Fan J, Yao J, Si H, Xie H, Ge T, Ye W, Chen J, Yin Z, Zhuang F, Xu L, Su H, Zhao S, Xie X, Zhao D, Wu C, Zhu Y, Ren Y, Xu N, Chen C; Surgical Thoracic Alliance of Rising Star Group. Frozen sections accurately predict the IASLC proposed grading system and prognosis in patients with invasive lung adenocarcinomas. Lung Cancer. 2023 Apr;178:123-130.
  • 7. Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106(7):1262-1267.
  • 8. Khorana AA, Tullio K, Elson P, Pennell NA, Grobmyer SR, Kalady MF, Raymond D, Abraham J, Klein EA, Walsh RM, Monteleone EE, Wei W, Hobbs B, Bolwell BJ. Time to initial cancer treatment in the United States and association with survival over time: An observational study. PLoS One. 2019 Mar 1;14(3):e0213209.
  • 9. Rao SS, Saha S. Timeliness of lung cancer diagnosis and treatment: a single-center experience. Asian Cardiovasc Thorac Ann. 2019;27(8):670-676.
  • 10. Schultz EM, Powell AA, McMillan A, et al. Hospital characteristics associated with timeliness of care in veterans with lung cancer. Am J Respir Crit Care Med2009;179: 595–600.
  • 11. Yorio JT, Xie Y, Yan J and Gerber DE. Lung cancerdiagnostic and treatment intervals in the United States: ahealth care disparity?J Thorac Oncol2009; 4: 1322–1330.17.
  • 12. Schultz EM, Powell AA, McMillan A, et al. Hospitalcharacteristics associated with timeliness of care in veter-ans with lung cancer.Am J Respir Crit Care Med2009;179: 595–600.18.
  • 13. Olsson JK, Schultz EM and Gould MK. Timeliness of care in patients with lung cancer: a systematic review.Thorax2009; 64: 749–756.
  • 14. Vidaver RM, Shershneva MB, Hetzel SJ, Holden TR andCampbell TC. Typical time to treatment of patients withlung cancer in a multisite, US-based study.J Oncol Pract2016; 12: e643–e653.
  • 15. Alberts WM, Bepler G, Hazelton T, Ruckdeschel JC andWilliams JH Jr; American College of Chest Physicians.Practice organization.Chest2003; 123: 332S–337S
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Göğüs Cerrahisi
Bölüm Orjinal Araştırma
Yazarlar

Merve Şengül İnan 0000-0001-5520-7314

Kubilay İnan 0000-0002-1409-4760

İlknur Aytekin Çelik 0000-0003-0754-680X

Nurettin Karaoglanoglu 0000-0003-2827-6044

Yayımlanma Tarihi 30 Eylül 2023
Kabul Tarihi 24 Eylül 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

AMA Şengül İnan M, İnan K, Aytekin Çelik İ, Karaoglanoglu N. Evaluation of the effect of intraoperative frozen section on overall timeliness and survival in lung cancer surgery. J Contemp Med. Eylül 2023;13(5):891-895. doi:10.16899/jcm.1347963