SURGICAL TREATMENT OF PATIENTS WITH RESECTABLE NON SMALL CELL LUNG CANCER

Autor: K. I. Kolbanov, A. Kh. Trakhtenberg, O. V. Pikin, V. A. Glushko, A. B. Ryabov
Jazyk: ruština
Rok vydání: 2015
Předmět:
Zdroj: Issledovaniâ i Praktika v Medicine, Vol 1, Iss 1, Pp 16-23 (2015)
Druh dokumentu: article
ISSN: 2410-1893
2409-2231
DOI: 10.17709/2409-2231-2014-1-1-16-23
Popis: Objective. Study based on long-term results of treatment of patients with resectable non-small cell lung cancer using surgical method specified prognostic factors.Materials and methods. The analysis of surgical and multimodal treatment in 1420 patients with NSCLC. In 42.7% of patients metastases in the lymph nodes were absent in 28.1% revealed bronchopulmonary defeat and root nodes (N1), while 28.9% - mediastinal (N2). Radical surgery performed 92.8% of patients. Postoperative complications were diagnosed in 22.2%. The case fatality rate - 3.0%.Results. The overall five-year survival of patients after radical treatment was 42,0 ± 1,6%, palliative - 19,8 ± 3,3%. When radical treatment for more than 5 years experienced a 65,0 ± 3,6% of patients with stage IA, 54,5 ± 3,4% - IB, 49,0 ± 5,2% - IIA, 40,8 ± 4,0% - IIB, 18,8 ± 2,5% - IIIA and 13,4 ± 5,8% - IIIB. In patients with N0 long-term results of treatment amounted to 58,4 ± 2,4%, were higher in squamous cell carcinoma (62,1 ± 3,5%), than adenocarcinoma (52,5 ± 4,6% p = 0.048) and largecancer (45,5 ± 7,7%, p = 0.008). Indicators of five-year survival after radical combined treatment in patients with N + were lower (30,9 ± 2,3%) and depended on the level of the lesion nodes (N1 or N2), interest areas of the mediastinum, the morphological structure of the tumor, as well as the volume of transactions.Conclusions. Radical surgical and combined treatment (with postoperative radiotherapy) can be carried out by most of the patients with resectable non-small cell lung cancer with satisfactory long-term results. The main prognostic factors should be considered the type of the treatment, stage of disease, especially the state of regional hilar lymph nodes. Additional adverse prognostic factor in patients with N0 is adenogenous and macrocellular morphological type of cancer, at N1 - T4 tumors and macrocellular carcinoma, and N2 - Metastasis in some or all areas of the mediastinum and the volume of surgery - bilobectomy.
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