Akciğer rezeksiyonu uygulanan erken evre akciğer kanserinde sağkalım ve sağkalımı etkileyen prognostik faktörler
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Dünyada ve ülkemizde en öldürücü kanser olan akciğer kanserinin enetkin tedavisi geride tümörün bırakılmadığı komplet eksizyondur. Tanı anında hastaların yalnızca %25'i cerrahi tedaviye uygun olsa da özellikle ileri evrede küratif operabilite oranı ve sağkalım daha düşük olduğundan hastalığın erken evrede teşhisi daha da önem kazanmaktadır. Çalışmamızda erken evre hastalarda tedavi yönetimini daha optimal hala getirmek amacıyla preoperatif, intraoperatif ve postoperatif değişikliklerin hastalık prognozu üzerine olan etkisini ortaya koymayı amaçladık. Gereç ve yöntemler: Bu çalışmada; İnönü Üniversitesi Tıp Fakültesi Göğüs CerrahisiAnabilim Dalında 2012-2021 yılları arasında komplet eksizyon ile opere edilen histopatolojikolarak erken evre(Evre 1A-B) akciğer kanseri tanısı alan olguların verileri retrospektif incelenerek değişik faktörlere bağlı sağkalım analizleri yapıldı. Bulgular: Hastaların ortalama sağkalım süresi 110,39 ay ve genel sağkalımı ,3 olarak saptandı. Preoperatif nefes darlığı varlığı (p=0,003), erkek cinsiyet (p=0,044), hastaların 65 yaş üstü olması (p=0,002), cerrahi prosedür olarak torakotomi tercihi (p=0,043), fissürün komplet olması (p=0,016), intraoperatif komplikasyon varlığı (p<0,001) histopatolojik tanısı skuamöz hücreli karsinom(SHK) olması (p=0,021), lenfovasküler invazyon varlığı (p=0,019), Evre 1B(T2A) olması(p=0,031), postoperatif dönemde kemoterapi alması (p=0,008), postoperatif dönem takiplerinde kemik metastazı izlenmesi (p<0,001) sağkalım üzerinde istatistiksel olarak anlamlı bulundu. Bu faktörlerle yapılan regresyon analizinde; nefes darlığı varlığı, yaş, torakotomi tercihi, intraoperatif komplikasyon, SHK tanısı, lenfovasküler invazyon varlığı sağkalım üzerinde bağımsız birer negatif prognostik faktör olarak saptandı. Sonuçlar: Erken evre akciğer kanserinde en etkin tedavi lenf nodu diseksiyonu ile beraber yapılmış komplet anatomik rezeksiyonlardır. İleri yaş, artan komorbiditeler ve düşük hasta performansı gibi nedenlerden dolayı sublober rezeksiyonlar opsiyonel olarak düşünülse de yaygın tercih lobektomi prosedürüdür. Giderek yaygınlaşan minimal invaziv cerrahi yöntemlerle torakotomiye göre çalışmamızda hastaların sağkalımında istatiksel olarak anlamlı farklılıklar izlendi. Anahtar kelimeler; akciğer kanseri, evre 1A-1B, erken evre, rezeksiyon, sağkalım.
Introduction: The most effective treatment for lung cancer, which is the most lethal cancer in the world and in our country, is complete excision without leaving the tumor behind It is crucial to diagnose the disease at an early stage, as only 25% of patients are suitable for surgical treatment at diagnosis. This becomes even more critical because the curative operability rate and survival rate are lower in the advanced stage. Our goal is to uncover the impact of preoperative, intraoperative, and postoperative changes on disease prognosis to improve treatment management for early-stage patients. Material and methods: In this study, we analyzed the data of patients with early- stage lung cancer who underwent complete excision at the Department of Thoracic Surgery of İnönü University Faculty of Medicine between 2012-2021. The histopathological diagnosis of each patient was taken into consideration, and survival analyses were conducted based on various factors. The results of this study provide valuable insights into the prognosis of early-stage lung cancer patients who undergo surgery. Results: The mean survival time of the patients was 110.39 months and the overall survival was 84.3%. Presence of preoperative dyspnea (p=0.003), male gender (p=0.044), patients over 65 years of age (p=0.002), preference for thoracotomy as a surgical procedure (p=0.043), complete fissure (p=0.016), intraoperative presence of complications (p<0.001), pathology of squamous ca (p=0.021), presence of lymphovascular invasion (p=0.019), Stage 1B (T2A) (p=0.031), receiving chemotherapy in the postoperative period (p=0.008), postoperative period In the follow-ups, bone metastasis (p<0.001) was found to be significant on survival. In the regression analysis made with these factors; Presence of dyspnea, age, thoracotomy preference, intraoperative complication, pathology, squamous ca, presence of lymphovascular invasion were found as independent negative prognostic factors on survival. Conclusion: For early-stage lung cancer, the most effective treatment involves complete anatomical resections combined with lymph node dissection. While sublobar resections may be considered for patients with advanced age, increased comorbidities, and poor performance, the preferred option is usually the lobectomy procedure. The use of minimally invasive surgical methods has resulted in statistically significant differences in patient survival compared to thoracotomy. Keywords: Lung cancer, stage 1A-1B, early stage, resection, survival
Introduction: The most effective treatment for lung cancer, which is the most lethal cancer in the world and in our country, is complete excision without leaving the tumor behind It is crucial to diagnose the disease at an early stage, as only 25% of patients are suitable for surgical treatment at diagnosis. This becomes even more critical because the curative operability rate and survival rate are lower in the advanced stage. Our goal is to uncover the impact of preoperative, intraoperative, and postoperative changes on disease prognosis to improve treatment management for early-stage patients. Material and methods: In this study, we analyzed the data of patients with early- stage lung cancer who underwent complete excision at the Department of Thoracic Surgery of İnönü University Faculty of Medicine between 2012-2021. The histopathological diagnosis of each patient was taken into consideration, and survival analyses were conducted based on various factors. The results of this study provide valuable insights into the prognosis of early-stage lung cancer patients who undergo surgery. Results: The mean survival time of the patients was 110.39 months and the overall survival was 84.3%. Presence of preoperative dyspnea (p=0.003), male gender (p=0.044), patients over 65 years of age (p=0.002), preference for thoracotomy as a surgical procedure (p=0.043), complete fissure (p=0.016), intraoperative presence of complications (p<0.001), pathology of squamous ca (p=0.021), presence of lymphovascular invasion (p=0.019), Stage 1B (T2A) (p=0.031), receiving chemotherapy in the postoperative period (p=0.008), postoperative period In the follow-ups, bone metastasis (p<0.001) was found to be significant on survival. In the regression analysis made with these factors; Presence of dyspnea, age, thoracotomy preference, intraoperative complication, pathology, squamous ca, presence of lymphovascular invasion were found as independent negative prognostic factors on survival. Conclusion: For early-stage lung cancer, the most effective treatment involves complete anatomical resections combined with lymph node dissection. While sublobar resections may be considered for patients with advanced age, increased comorbidities, and poor performance, the preferred option is usually the lobectomy procedure. The use of minimally invasive surgical methods has resulted in statistically significant differences in patient survival compared to thoracotomy. Keywords: Lung cancer, stage 1A-1B, early stage, resection, survival
Açıklama
Tıp Fakültesi, Göğüs Cerrahisi Ana Bilim Dalı
Anahtar Kelimeler
Göğüs Cerrahisi, Thoracic Surgery
