Prognoza bolesti nakon operacijskog liječenja karcinoma pluća u Kliničkom bolničkom centru (KBC) Split

Objectives: The aim of this study was to determine the length of survival without disease recurrence in relation to the type of surgical procedure and histologic type of lung cancer, to analyze the impact of surgical approach on number of extirpated lymph nodes, to analyze the impact of number of extracted and positive lymph nodes on the mediastinal metastases occurence. Subjects and Methods: From December 2012 until September 2017, 70 patients (45 males, 25 females) who underwent surgery for the treatment of non-small-cell lung cancer at the Department of Surgery, University Hospital of Split, were included in the retrospective study. Patients were divided according to the type of surgical approach, histologic type of lung cancer, location of metastases and number of affected and isolated lymph nodes. Results: Between 2012 and 2017, 70 patients were treated surgically for non-small-cell lung cancer either by VATS or open thoracotomy approach. The median age of patients was 65 years. The most frequently diagnosed histologic type was adenocarcinoma (n=47). Lungs were the most common site for metastatic spread. When analyzing the impact of surgical approach on number of affected and isolated lymph nodes there was no statistical difference (P=0.237), (P=0.194). There was no difference between number of affected and isolated lymph nodes with location of metastases (P=0.645, P=0.895). Disease free survival was 17 months shorter in patients with metastases in mediastinum than in patients with metastases in the lungs and 12 months shorter than in patients with metastases in other locations. There was no significant difference of disease free survival between genders (P=0.610), histologic types (P=0.688), age groups (P=0.838), type of surgical approach (P=0.527) and number of affected (P=0.643) and isolated (P=0.499) lymph nodes. Conclusion: Type of surgical approach does not have an impact on number of removed lymph nodes and disease free survival.Ciljevi: Cilj ovog istraživanja bio je odrediti duljinu preživljenja bez povrata bolesti s obzirom na tip kirurškog pristupa i histološki tip karcinoma pluća, analizirati utjecaj kirurškog pristupa na broj ekstirpiranih limfnih čvorova te analizirati utjecaj broja pozitivnih i izvađenih limfnih čvorova na pojavu metastaza u medijastinumu. Ispitanici i metode: Od prosinca 2012 do rujna 2017, 70 ispitanika (45 muškaraca, 25 žena) koji su kirurški liječeni zbog nesitnostaničnog karcinoma pluća na Klinici za kirurgiju, KBC-a Split, bili su uključeni u ovu retrospektivnu studiju. Ispitanici su bili podijeljeni u skupine s obzirom na tip kirurškog pristupa, histološki tip karcinoma pluća, lokaciju metastaze i broj zahvaćenih i izoliranih limfnih čvorova. Rezultati: Između 2012 i 2017.godine, 70 ispitanika je kirurški liječeno zbog nesitnostaničnog karcinoma pluća VATS pristupom ili pristupom otvorene torakotomije. Medijan životne dobi ispitanika bio je 65 godina. Najčešće dijagnosticirani histološki tip bio je adenokarcinom (n=47). Najčešća lokacija metastaza bila su pluća. Analizirajući utjecaj kirurškog pristupa na broj zahvaćenih i izoliranih limfnih čvorova nije bilo statistički značajne razlike (P=0.237, P=0.194). Između broja zahvaćenih i izoliranih limfnih čvorova te lokacija metastaza nije bilo statistički značajne razlike (P=0.645, P=0.895). Duljina preživljenja je bila 17 mjeseci kraća kod ispitanika s metastazama u medijastinumu za razliku od ispitanika s metastazama na plućima te 12 mjeseci kraća za razliku od pacijenata s metastazama na drugim lokacijama. Nije bilo statistički značajne razlike u duljini preživljenja između spola (P=0.610), histološkog tipa (P=0.688), dobi (P=0.838), tipa kirurškog pristupa (P=0.527) i broja zahvaćenih (P=0.643) i izoliranih (P=0.499) limfnih čvorova. Zaključak: Tip kirurškog pristupa nema utjecaj na broj uklonjenih limfnih čvorova i duljinu preživljenja