Evre III küçük hücre dışı akciğer kanserli hastalarda sekizinci evreleme sisteminin prognostik etkileri

Yıl 2019, Cilt: 11 Sayı: 1, 47 - 53, 31.03.2019

Gül Kanyılmaz Meryem Aktan Berrin Benli Yavuz Lütfi Saltuk Demir

https://doi.org/10.21601/ortadogutipdergisi.377255

Öz

Amaç: Ocak 2017’ de akciğer kanserinin tümör, nod ve metastaz
(TNM) evreleme sınıflamasının 8. versiyonu yayımlanmıştır. Bu araştırmada evre
III küçük hücreli dışı akciğer kanseri (KHDAK) tanısıyla küratif
kemoradyoterapi (KRT) uygulanan hastalarda 7. ve 8. evreleme sisteminin
etkilerini karşılaştırmak ve gruplar arasındaki sağkalım farkını incelemek amaçlanmıştır.

Gereç
ve Yöntemler: Ocak 2010 ve Ocak 2017
tarihleri arasında KHDAK tanısıyla başvuran hastalardan klinik evre III kabul
edilerek küratif KRT uygulanan hasta verileri geriye dönük incelendi. 8.
versiyona göre olan T-evre ve TNM evre değişimleri kaydedildi. Eski ve yeni T-evre,
N-evre ve TNM evre kategorilerine göre sağkalım analizleri yapıldı.

Bulgular: Toplam 112 evre III KHDAK’li hastanın değerlendirildiği çalışmada
33 hastanın (%30) T-evresinde değişme saptanırken, 47 (%42) hastanın TNM evresinde değişiklik olmuştur. İleri yaş,
takip sırasında uzak organ metastazı gelişmesi, TNM evresi ve N-evresi sağkalımı
etkileyen bağımsız prognostik faktörler olarak bulunmuştur.

Sonuç: Sekizinci TNM evreleme sınıflamasına göre tümör
boyutu alt gruplara bölünerek T-evresinin yeniden sınıflandırılması lokal ileri
evre KHDAK’li hastalarda sağkalımı etkileyen bir parametre olarak
bulunmamıştır. Evre IIIa ve IIIc hastalar arasında anlamlı, evre IIIa ve IIIb
hastalar arasında anlamlılığa yakın bir sağkalım farkı bulunmasına rağmen evre
IIIb ve IIIc hastalar arasında anlamlı sağkalım farkı bulunamamıştır. N3
hastalığa sahip olmak tek başına sağ kalımı öngörecek bağımsız prognostik bir
faktör olarak saptanmıştır. 

Anahtar Kelimeler

küçük hücreli dışı akciğer kanseri, prognostik faktörler, radyoterapi, evreleme

The prognostic effects of new eighth staging system for stage III non-small cell lung cancer

Öz

Aim: The eighth tumour, node and metastasis (TNM) staging system for lung
cancer was published in January 2017. To compare the newly released 8^thversion
of TNM staging system with 7^th version of TNM staging system in
stage III non-small cell lung cancer patients (NSCLC) treated with curative
chemo-radiotherapy (CRT) and to evaluate the survival differences between the
groups were the aims of this study.

Material and Methods: Between January 2010 and January 2017, stage III NSCLC
patients who were treated with curative CRT were identified retrospectively.
Changes in T-stage and TNM-stage were according to 8^thstaging system
were recorded. Survival analysis were performed by using T-stage, N-stage and
TNM stage in each staging system, respectively.

Results: One hundred and twelve patients were included in this study. Of these 33
patients (30%) showed change in T-stage, whereas 47 patients (42%) had change
in TNM stage. Advanced age, distant organ metastasis during follow-up, TNM stage
and N-stage progression was found as independent prognostic factors affecting
survival.  

Conclusion: According to 8^th TNM staging system, subdivision of T-stage by tumour size did not affect the survival parameters
in locally advanced NSCLC patients. On the other hand, we found significant
survival difference between stage IIIa and IIIc. In regards of survival, although
there was a significant difference between patients with IIIa and IIIc, and
almost significance between patients with IIIa and IIIb, there was no significance
between stage IIIb and IIIc patients. Having N3 nodal disease was found to be
an independent prognostic factor of survival.

Anahtar Kelimeler

non-small cell lung cancer, prognostic factors, radiotherapy, staging

Kaynakça

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