Surgical outcomes of large cell neuroendocrine carcinoma of the lung

Yıl 2019, Cilt: 10 Sayı: 4, 474 - 478, 31.12.2019

Fazlı Yanık , Yekta Altemur Karamustafaoğlu , Yener Yoruk

https://doi.org/10.18663/tjcl.479216

Öz

Aim:
‘Large cell neuroendocrine carcinoma of the lung’ (LCNECL) is high-grade rare
tumors and has clinical and biological characteristics similar to small cell
lung cancer. In this study, we evaluated the surgical results, prognosis and
survival of the patients with histopathologically LCNECL.

Materials and Methods: Twelve
patients, one female and 11 male,  with a
mean age of 61,4±7,5(48-74 years), who were reported as LCNECL between June
2012 and June 2018 was performed resection, were evaluated retrospectively.
Prognosis, age, sex, smoking history, tumor size, diagnostic treatment
modalities, surgical outcomes and survival was analyzed from hospital records.

Results: While
in eight cases the tumor was located in the right hemithorax, in four cases was
left hemithorax. Mediastinoscopy and anatomic lung resection with mediastinal
lymph node dissection were performed in 11 cases. In one case with T1 stage,
video-assisted lobectomy and mediastinal lymph node dissection were performed
without mediastinoscopy because there was no pathological lymph node in the mediastinum
in chest computerized tomography. Seven patients (58%) died due to tumor
progression or metastasis during follow-up. The median tumor size, median
survival time, median disease-free survival time and median lenght of hospital
time were 4.4±2.1cm (range1-8cm),
17.9±19.04months(range2-72months), 15,08±19.6months(range1-72months) and
6,4±3,6days(4-12days), respectively. There was no postoperative mortality.
Two(16%) patients with complications (atelectasis and wound infection) were
observed.

Conclusion: Although
they have similar features with small cell lung cancer in terms of treatment
and survival rates, no consensus have been identified in their treatment
strategy. Today, curative anatomic resections and accompanying oncological
therapies seem to be the only chance for long-term survival. However, there is
a need for studies including larger case series about these rare tumors

Anahtar Kelimeler

lung tumor

Akciğerin büyük hücreli nöroendokrin karsinomundaki cerrahi sonuçlarımız

Öz

Giriş/Amaç: Akciğerin büyük hücreli
nöroendokrin karsinomları (BHNK) yüksek dereceli nadir  tümörlerdir ve küçük hücreli akciğer kanserine
benzer klinik ve biyolojik özellikler taşırlar. Bu çalışmada histopatolojik
tanısı akciğerin BHNK’u olan olgulardaki cerrahi sonuçlarımızı, prognozu ve
sağkalımı irdeledik.

Materyal-Metod:
Haziran 2012-Haziran
2018 tarihleri arasında rezeksiyon yapılan ve patolojik tanıları BHNK olarak
raporlanan biri kadın, 11’i erkek, ortalama yaşları 61,4±7,5(48-74 yaş) olan 12
olgu retrospektif olarak değerlendirildi. Prognoz, yaş, cins, sigara içme
hikayesi, tümör çapı, tanı tedavi modaliteleri, cerrahi sonuçlar ve sağkalım
hastane kayıtlarından analiz edildi.

Bulgular:
Sekiz olguda tümör
sağ hemitoraks yerleşimli iken, dört olguda sol hemitoraks yerleşimliydi. 11
olguda mediastinoskopi ve anatomik akciğer rezeksiyonu ile mediastinal lenf
nodu diseksiyonu uygulandı. T1 evreli bir olgu ise bilgisayarlı toraks
tomografisinde mediastende patolojik lenf nodu olmadığı için, mediastinoskopi
yapılmadan, video yardımlı lobektomi ve mediastinal lenf nodu diseksiyonu
uygulandı. Olguların yedisi (%58) takipler sırasında metastaz veya tümör progresyonu
nedeniyle 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. Postoperatif
mortalite görülmedi. İki(%16) olguda komplikasyon (atelektazi ve yara yeri
enfeksiyonu) görüldü.

Sonuç:
Tedavi ve sağ-kalım
açısından küçük hücreli akciğer kanserine benzer özellikler taşısa da, tedavi
stratejisinde tam olarak bir fikir birliğinin sağlanamamıştır. Günümüzde küratif
anatomik rezeksiyonlar ve beraberinde eklenecek onkolojik tedaviler uzun dönem
sağ-kalım için tek şans gibi gözükmektedir. Ancak bu nadir görülen tümörlerle
ilgili daha geniş vaka serilerini içeren çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

akciğer, tümör, nöroendokrin

Kaynakça

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