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Citak N.,Kars State Hospital | Buyukkale S.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | Sayar A.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | Metin M.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | And 2 more authors.
Acta Chirurgica Belgica | Year: 2014

Background: Surgical treatment of T4 non-small cell lung carcinoma (NSCLC) is controversial. Methods: Between 1998 and 2011, 70 patients undergoing pulmonary resection for T4 NSCLC were evaluated. The patients were divided into four groups: the large vessels group (n = 28), the carinal group (n = 20), the separate tumor nodules group (n = 13) and the mediastinal fat group (n = 9). Results: Overall mortality and morbidity were 12.9% (n = 9) and 35.7% (n = 25), respectively and there was no significant differences between the four groups (p = 0.961, p = 0.750). Complete resection was possible in 47 patients (67.1%). The pathological nodal status was as follows: N0/1 in 58 patients and N2 in 12 patients. Five-year survival rate was 28.9% for all patients and 49.6%, 18.5%, 0% and 20.5% in the carinal, large vessels, mediastinal fat and separate tumor nodule groups, respectively. The carinal group was significantly different from the other groups in terms of survival (p = 0.05). By multivariate analysis, only two factors significantly and independently influenced survival: nodal status (N0/N1 versus N2 ; p = 0.01) and complete resection (R0 versus R1 ; p = 0.06). Conclusion: Resection is not a suitable approach for T4 NSCLC patients with N2 disease or incomplete resection. Resectable T4 NSCLC patients with carinal or tracheal involvement have better survival than do other T4 sub-groups. © Acta Chirurgica Belgica.


Citak N.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | Sayar A.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | Metin M.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | Buyukkale S.,Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital | And 4 more authors.
Thoracic and Cardiovascular Surgeon | Year: 2015

Introduction: We investigated the prognostic effect of lymph nodes metastasis in aortopulmonary (AP) zone in resected non-small cell lung cancer of the left upper lobe (LUL). Methods:Between 1998 and 2010, 181 patients with LUL carcinoma underwent complete resection and were retrospectively analyzed. The patients were divided into four groups according to N status: N0 (n=68, 37.6%), N1 (n=64, 35.3%), N25,6+ (only metastasized to stations 5 and/or 6, n=36, 19.9%), and N27+ (only metastasized to stations 7, n=13, 7.2%). N1 were divided according to single and multiple (N1single n=49, N1multiple n=15) or peripheral and hilar (N1peripheral n=39, N1hilar n=25). Results:Overall 5-year survival rate was 55.1%. Five-year survivals were 76.1% for N0, 54.3% for N1, and 20.7% for N2. N1peripheral had a better survival than N1hilar (60.3 vs. 29.4%, p=0.09). Five-year survival of N1single was 60.1%, whereas it was 36.6% for N1multiple (p=0.02). Five-year survival rate was 24.6% for N25,6+. Skip metastasis for lymph nodes in AP zone (n=13) was a factor of better prognosis as compared to nonskip metastasis (n=23) (29.9 vs. 19.2%). There was no statistically significant difference between the N25,6+ and N1hilar (p=0.772), although N1peripheral had a significantly better survival than N25,6+ (p=0.02). AP zone metastases alone had a significantly worse survival than N1single (p=0.008), whereas there was no statistically significant difference between the N1multiple and N25,6+ (p=0.248). N27+ was not expected to survive 3 years after operation. They had a significantly worse prognosis than N25,6+ (p=0.02). Conclusion LUL tumors with metastasis in the AP zone lymph nodes, especially skip metastasis, were associated with a more favorable prognosis than other mediastinal lymph nodes. However, the therapy of choice for lung cancer with N25,6+ has not been clarified yet. © 2015 Georg Thieme Verlag KG Stuttgart. New York.


PubMed | Yedikule Thoracic Surgery and Chest Disease Training and Research Hospital
Type: Journal Article | Journal: The Thoracic and cardiovascular surgeon | Year: 2015

We investigated the prognostic effect of lymph nodes metastasis in aortopulmonary (AP) zone in resected non-small cell lung cancer of the left upper lobe (LUL).Between 1998 and 2010, 181 patients with LUL carcinoma underwent complete resection and were retrospectively analyzed. The patients were divided into four groups according to N status: N0 (n=68, 37.6%), N1 (n=64, 35.3%), N2(5,6+) (only metastasized to stations 5 and/or 6, n=36, 19.9%), and N2(7+) (only metastasized to stations 7, n=13, 7.2%). N1 were divided according to single and multiple (N1(single) n=49, N1(multiple) n=15) or peripheral and hilar (N1(peripheral) n=39, N1(hilar) n=25).Overall 5-year survival rate was 55.1%. Five-year survivals were 76.1% for N0, 54.3% for N1, and 20.7% for N2. N1(peripheral) had a better survival than N1(hilar) (60.3 vs. 29.4%, p=0.09). Five-year survival of N1(single) was 60.1%, whereas it was 36.6% for N1(multiple) (p=0.02). Five-year survival rate was 24.6% for N2(5,6+). Skip metastasis for lymph nodes in AP zone (n=13) was a factor of better prognosis as compared to nonskip metastasis (n=23) (29.9 vs. 19.2%). There was no statistically significant difference between the N2(5,6+) and N1(hilar) (p=0.772), although N1(peripheral) had a significantly better survival than N2(5,6+) (p=0.02). AP zone metastases alone had a significantly worse survival than N1(single) (p=0.008), whereas there was no statistically significant difference between the N1(multiple) and N2(5,6+) (p=0.248). N2(7+) was not expected to survive 3 years after operation. They had a significantly worse prognosis than N2(5,6+) (p=0.02).LUL tumors with metastasis in the AP zone lymph nodes, especially skip metastasis, were associated with a more favorable prognosis than other mediastinal lymph nodes. However, the therapy of choice for lung cancer with N2(5,6+) has not been clarified yet.

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