Abstract
Background: This study aims to evaluate surgical outcomes and prognosis in patients who underwent extended lung resection for locally advanced lung cancer.
Methods: Between January 2015 and December 2019, a total of 61 patients (60 males, 1 female; mean age: 61.7±12.2 years; range, 32 to 90 years) with locally advanced non-small-cell lung cancer who underwent extended lung resection were retrospectively analyzed. Data including age, sex, comorbid diseases, symptoms, smoking status, pulmonary function test results, tumor location, methods used for preoperative tissue diagnosis, histopathological cell type, type of surgical resection, pathological stage, nodal involvement, postoperative complications, types of adjuvant therapy, and mortality rate were recorded. Survival and the factors affecting survival were examined.
Results: Seven (11.4%) patients had Stage IIIB, 40 (65.5%) patients had Stage IIIA, and 14 (22.9%) patients had Stage IB disease. Intrapericardial pneumonectomy accounted for 30 (49.1%) of all extended lung resections. Chemotherapy was administered to 31 (50.8%) patients and chemoradiotherapy to 24 (39.3%) patients in the postoperative period. In the survival analysis, 70-month survival rate was calculated as 63.9% and the median survival was 48 months. There was a statistically significant association between survival with adjuvant chemotherapy and chemoradiotherapy (p=0.003). The mortality rate at 70 months of follow-up was 36.1%.
Conclusion: Extended lung resection contributes significantly to the improvement of survival rates in carefully selected locally advanced cases. Particularly with adjuvant chemotherapy, local recurrences can be prevented, and survival rates can be improved.
Publisher
Baycinar Tibbi Yayincilik
Subject
General Engineering,Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,Surgery
Reference24 articles.
1. Crinò L, Weder W, van Meerbeeck J, Felip E; ESMO Guidelines Working Group. Early stage and locally advanced (nonmetastatic) non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21 Suppl 5:v103-15. doi: 10.1093/annonc/mdq207.
2. Yaran P, Yazıcı Ü, Taştepe Aİ. Akciğer kanserinde genişletilmiş rezeksiyonlar. J Clin Anal Med 2010:32-40.
3. Choi HS, Jeong BK, Jeong H, Lee YH, Ha IB, Song JH, et al. Application of the new 8th TNM staging system for non-small cell lung cancer: Treated with curative concurrent chemoradiotherapy. Radiat Oncol 2017;12:122. doi: 10.1186/ s13014-017-0848-2.
4. Downey RJ, Martini N, Rusch VW, Bains MS, Korst RJ, Ginsberg RJ. Extent of chest wall invasion and survival in patients with lung cancer. Ann Thorac Surg 1999;68:188-93. doi: 10.1016/s0003-4975(99)00456-7.
5. LoCicero III J. Results of surgical treatment of non-small cell lung cancer. In: Shields TW, editor. 8th ed. General thoracic surgery. Philadelphia: Lippincott Williams & Wilkins; 2018. p. 1222-52.