Akciğer kanser cerrahisinde onkolojik prensipler

Yıl 2021, Cilt: 12 Sayı: 2, 223 - 231, 30.06.2021

Murat Öncel , Aydın Şanlı Hüseyin Yıldıran

https://doi.org/10.18663/tjcl.445743

Öz

Küçük hücre dışı akciğer kanserlerinde cerrahi başarı, iyi bir anatomik rezeksiyon sonrası makroskobik ve mikroskobik olarak temiz gelen cerrahi sınır olması ve lenf nodlarında yayılım görülmemesidir. Cerrahi, akciğer kanserlerinde özellikle erken evrelerde en büyük tedavi şansını oluştururken tümör ve komşu dokuların birlikte anblok rezeksiyonları, cerrahi sınırda tümör dokusunun kalmayışı en uzun süreli sağkalımı sağlamaktadır. Küçük hücreli dışı akciğer kanserli hastaların yaklaşık %70’inde kullanılan lobektomi standart bir anatomik rezeksiyondur. Uygulanan teknik pulmoner venlerin, arterin ve bronşun ayrı ayrı serbestleştirilmesi ve ardından mutlak bir şekilde hiler lenf nodları ve lenfatiklerin dikkatli diseksiyonudur. Akciğer rezeksiyonu geçirecek bütün hastalar için rezeksiyon öncesi evreleme; hastalığın seyri ve onkolojik girişimlerin algoritması için mutlaka yapılmalıdır.

Anahtar Kelimeler

Akciğer kanseri, cerrahi metodlar, , mediastinoskopi

Oncological principles for the lung cancer surgery

Öz

In non-small cell lung cancer, after resection they were not spread of macroscopic and microscopic if you want anatomic success as a good clean surgical margins and lymph nodes .In lung cancer surgery, while providing the greatest chance of total cure, tumor which they were not surrounding tissue, especially along the anblok resection, It will provide the long term living because of the resection margin was staying the clear from the cancer mass. Lobectomy is being used approximately 70% of patients with non small cell when used as a standard anatomical resection, Here in operative technique of the resection pulmonary veins, arteries and bronchi should carefully divised from other tissue , then the individual division is the hilar lymph nodes and lymphatics were resected by careful dissections. All patients if the undergoing lung resection, they should be detected pre-staging progression entries by the algorithm.

Anahtar Kelimeler

Lung cancer, surgical methods, mediastinoscopy

Kaynakça

• 1. Ding N, Zhou N, Zhou M, et al. Respiratory cancers and pollution. Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):31-7.
• 2. Rosell R. A randomise trial comparing preoperative chemotherapy plus surgery with surgery alone in patients NSCLC. N Engl J Med 1994;330:153-8.
• 3. Roth J. A randomise trial comparing preoperative chemotherapy and surgery alone in resectable stage III A NSCLC J Natl Cancer Inst 1994;86.673-80.
• 4. Vansteenkiste JF. Present status of induction treatment for N2 NSCLC: A review. Eur J Cardiothorac Surg 1998;13.1-12.
• 5. Koizumi K, Haragushi S Surgical treatment of lung cancer with vertebral invasion Ann Thorac Cardiovasc Surgy 2004 Aug;10(4):229-34.
• 6. Grunenwald D. H. Mazel C. Radical en bloc resection invading the spine. J Thorac Cardiovasc Surg 2002;123:271- 80.
• 7. Lucchi M, Viti A, Melfi F et al. III B- T4 NSCLC: Indications and results of surgical treatment. J Card Surg 2007 Jun;48(3):369-74.
• 8. AF Ravens. Mediastinal LN involvement in potentially resectable lung cancer: comparison of CT,PET and EUS wiht and wihtout fine needle aspiration. Chest 2003;123:442-51.
• 9. Grunenwald DH, Albain KS. The potential role of surgery after induction treatment. Semin Radiat Oncol. 2004 Oct;14(4):335-9.
• 10. Melfi F, Fanucchi O, Davini F, et al. Ten-year experience of mediastinal robotic surgery in a single referral centre. Eur J Cardiothorac Surg. 2012 Apr;41(4):847-51.
• 11. Sonett JR, Suntharalingam M, Edelman MJ, et al. Pulmonary resection after curative intent radiotherapy (>59 Gy) and concurrent chemotherapy in non-small-cell lung cancer. Ann Thorac Surg. 2004 Oct;78(4):1200-5.
• 12. Daly BD, Fernando HC, Ketchedjian A, et al. Pneumonectomy after high-dose radiation and concurrent chemotherapy for nonsmall cell lung cancer. Ann Thorac Surg. 2006 Jul;82(1):227-31.
• 13. Fowler WC, Langer CJ, Curran WJ Jr, et al. Postoperative complications after combined neoadjuvant treatment of lung cancer. Ann Thorac Surg. 1993 Apr;55(4):986-9.
• 14. Dassanayake DL, Muthunayake TM, Senevirathna KH, et al. Staging of lung cancer in a tertiary care setting in Sri Lanka, using TNM 7th edition. A comparison against TNM6. BMC Res Notes. 2012 Mar 14;5.143.
• 15. Chien CR, Yang ST, Chen CY, et al. Impact of the new lung cancer staging system for a predominantly advanced-disease patient population. J Thorac Oncol. 2010 Mar;5(3):340-3.
• 16. Shepherd FA, Crowley J, Van Houtte P, et al; International Association for the Study of Lung Cancer International Staging Committee and Participating Institutions. The International Association for the Study of Lung Cancer lung cancer staging project: proposals regarding the clinical staging of small cell lung cancer in the forthcoming (seventh) edition of the tumor, node, metastasis classification for lung cancer. J Thorac Oncol. 2007 Dec;2(12):1067-77.
• 17. Giroux DJ, Rami-Porta R, Chansky K, et al, International Association for the Study of Lung Cancer International Staging Committee. The IASLC Lung Cancer Staging Project: data elements for the prospective project. J Thorac Oncol. 2009 Jun;4(6):679-83.
• 18. Jones KD. An update on lung cancer staging. Adv Anat Pathol. 2010 Jan;17(1):33-7.
• 19. Yoshida J, Nagai K, Asamura H, et al. Japanese Joint Committee for Lung Cancer Registration. Visceral pleura invasion impact on non-small cell lung cancer patient survival: its implications for the forthcoming TNM staging based on a large-scale nation-wide database. J Thorac Oncol. 2009 Aug;4(8):959-63.
• 20. Leuzzi G, Cesario A, Cafarotti S, et al. Surgical Treatment in Patient with Non-Small-Cell Lung Cancer with Fissure Involvement: Anatomical versus Nonanatomical Resection. J Thorac Oncol. 2013 Nov 19.
• 21. Ma Q, Liu D, Guo Y, et al. Surgical therapeutic strategy for non-small cell lung cancer with mediastinal lymph node metastasis (N2). Zhongguo Fei Ai Za Zhi. 2010 Apr;13(4):342-8.
• 22. Shields TW. Surgery of small cell lung cancer. Chest. 1986 Apr;89(4 Suppl):264S-267S. Review.
• 23. Charloux A, Quoix E, Wolkove N. The increasing incidence of lung adenocarcinoma, reality or artifact? A review of the epidemiology of lung adenocarcinoma. Int J Epidemiol 1997;26:14-23.
• 24. El-Torky M, El-Zeky F, Hall JC. Significant changes in the distribution of histologic types of lung cancer. Cancer 1990;65:2361-7.
• 25.Morabia A, Wynder EL. Cigarette smoking and lung cancer cell types. Cancer 1991;68:2074-8.
• 26. Wynder EL, Hoffmann D. Smoking and lung cancer, scientific challenges and opportunities. Cancer Res 1994;54:5284-95.
• 27. Jöckel KH, Ahrens W, Jahn I. Occupational risk factors for lung cancer, a case control study in West Germany. Int J Epidemiol 1998;27:549-60.
• 28. Mooi WJ. Common lung cancers. Hasleton PS (ed). Spencer’s Pathology of the lung. NewYork, Mc Graw Hill, 1996;100-9.
• 29. Halilçolar H, Tatar D, Ertuğrul G, et al. Epidemiyoloji. In: Çavdar T, Ekim N, Akkoçlu A, Öztürk C eds. Akciğer kanseri multidisipliner yaklaşım. 1.Baskı. Ankara: Bilimsel Tıp Yayınevi;1999:17-22.
• 30. Levi F, Franceschi S, Vecchia C. Lung carcinoma trends by histologic type in Vaud and Neuchatel, Switzerland, 1974-1994. Cancer 1997;79:906-14.
• 31. Ernster VL, Mustachhi P, Osann KE. Epidemiology of lung cancer . In: Textbook of Respiratory Medicine. Murray JF, Nadel JA (eds). 2nd edition. Philedelphia W.B. Saunders Co. 1994;1504-27.
• 32. Zheng T, Holford TR, Boyle P. Time trend and the age-period-cohort effect on the incidence of histologic types of lung cancer in Connecticut, 1960-1989. Cancer 1994;74:1556-67.
• 33. Boffa DJ, Allen MS, Grab JD, Gaissert HA, Harpole DH, Wright CD. Data from The Society of Thoracic Surgeons General Thoracic Surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg. 2008 Feb;135(2):247-54.
• 34. Postmus PE. Epidemiology of lung cancer. In: Fishman AP; ed. Fishman’s Pulmonary Diseases and Disorders. Third Edition. NewYork: McGraw-Hill Company; 1998:1707-17.
• 35. Utkaner G, Yılmaz U, Çelikten E, et al. Primer akciğer kanserli 116 olgunun analizi. Solunum Hastalıkları 1996;7:1-9.
• 36. Ginsberg RJ, Kris MG, Armstrong JG. Cancer of the Lung. In:DeVita VT, Hellman S, Rosenberg SA; eds. Cancer: Principles and Practice of Oncology. 4nd edition. Philedelphia: J.B. Lippincott Co; 1993:673-58.
• 37. Parkin DM, Sankaranarayanan R. Overview on small cell lung cancer in the world: Industrialized Countries, Third World, Eastern Europe. Anticancer Research 1994;14:277-82.
• 38. Altıay G, Tabakoğlu E, Çağlar T. 1993-1994 yılları arasında Trakya Üniversitesi Tıp Fakültesi’nde saptanan bronş kanserli hastaların değerlendirilmesi. Heybeliada Tıp Bülteni 1995;1:29-03.
• 39. Janssen-Heijnen MLG, Nab HW, van Reek J. Striking changes in smoking behaviour and lung cancer incidince by histological type in south-east Netherlands, 1960-1991. Eur J Cancer 1995;31:949-52.
• 40. Russo A, Crosignani P, Franceschi S, et al. Changes in lung cancer histological types in Varese cancer registry, Italy 1976-1992. Eur J Cancer 1997;33:1643-7.
• 41. Yaman M, Erturan S, Yılmaz Z . Kliniğimizin 44 yıllık akciğer kanseri hücre tipi sonuçları. In: Yaman M, Akkoçlu A, Kılınç G, Öztürk C, eds. Uluslararası akciğer kanseri ve bronkoskopi sempozyumu; 29 August – 01 September 2001; İstanbul, Turkey. 2001:SB-16.
• 42. Demir A, Turna A, Kocaturk C, et al. Prognostic significance of surgical-pathologic N1 lymph node involvement in non-small cell lung cancer. Ann Thorac Surg. 2009 Apr;87(4):1014-22.
• 43. Marra A, Hillejan L, Zaboura G, et al. Pathologic N1 non-small cell lung cancer: correlation between pattern of lymphatic spread and prognosis. J Thorac Cardiovasc Surg. 2003 Mar;125(3):543-53.
• 44. Yang H, Yao F, Zhao Y, et al. Clinical outcomes of surgery after induction treatment in patients with pathologically proven N2-positive stage III non-small cell lung cancer. J Thorac Dis 2015;7(9):1616-23.
• 45. Choi JH, Chung HC, Yoo NC . Changing trends in histologic types of lung cancer during the last decade (1981-1990) in Korea: a hospital-based study. Lung Cancer 1994;10:287-96.