Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Primer Akciğer Kanserlerinde Lenfanjitis Karsinomatozanın Evre ve Sağkalım Üzerine Etkisi
The Effect of Lymphangitis Carcinomatosa on the Stage, and Survival in the Primary Lung Cancers
Coşkun DOĞANa, Nesrin KIRALa, Elif TORUN PARMAKSIZa, Ali FİDANa, Banu SALEPÇİc, Benan ÇAĞLAYANd, Sevda Şener CÖMERTa, Recep DEMİRHANb
aGöğüs Hastalıkları Kliniği,
bGöğüs Cerrahisi Kliniği, Sağlık Bilimleri Üniversitesi Kartal Dr. Lütfi Kırdar Eğitim ve Araştırma Hastanesi,
cGöğüs Hastalıkları AD, Yeditepe Üniversitesi Tıp Fakültesi,
dGöğüs Hastalıkları AD, Koç Üniversitesi Tıp Fakültesi, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(1):48-55
doi: 10.5336/medsci.2018-62985
Article Language: TR
Full Text
ÖZET
 Amaç: Primer akciğer kanserlerinde lenfanjitis karsinomatoza (LK) varlığının evre ve sağkalım üzerine etkisini araştırmak. Gereç ve Yöntemler: Çalışmaya 2014-2016 yılları arasında primer akciğer kanser tanısı almış olgular dahil edildi. Olgular tanı aşamasında radyolojik olarak LK tespit edilen ve LK tespit edilmeyenler olarak iki gruba ayrıldı. İki gruptaki olguların demografik, klinik, radyolojik ve sağkalım özellikleri kayıt edildi. Her iki grubun verileri birbirleri ile karşılaştırıldı. Gruplara ait veriler Ki-kare ve Mann-Whitney U testleri ile değerlendirildi. Tüm testlerde p<0,05 istatistiksel anlamlı kabul edildi. Bulgular: Çalışmaya 264'ü (%82,2) erkek, 55'i (%17,8) kadın, yaş ortalaması 61,9±9,6 yıl olan toplam 319 olgu alındı. Ortalama sigara içme öyküsü 39,1±17,3 paket-yılı idi. Olguların 28'inde (%8,8) LK var iken, 291'inde (%91,2) LK yoktu. Olguların tümör histopatolojileri incelendiğinde her iki grupta da en sık görülen tümör cinsi skuamöz hücreli kanserdi. Lenfanjitis karsinomatoza tespit edilen ve edilmeyen olguların özellikleri (Histopatolojik tanı, evre, cerrahi/onkolojik tedavi özellikleri, sigara öyküsü, yaş, cinsiyet özellikleri) arasında fark bulunmadı. LK tespit edilen akciğer kanserlerinin ortanca genel sağkalım süreleri (11 ay) LK tespit edilmeyen özellikle evre 3B (12 ay) kanserler ile çok benzerdi (p=0,524). Sonuç: Varlığında sağkalım ve prognozun kötü etkilendiği bilinen LK, akciğer kanserlerinde sağkalımı etkilemektedir bu nedenle akciğer kanser evrelemelerinde dikkate alınmalıdır.

Anahtar Kelimeler: Akciğer kanseri; lenfanjitis karsinomatoza; sağkalım
ABSTRACT
 Objective: To investigate the effect of lymphangitis carcinomatosa on the stage, and survival in the primary lung cancers. Material and Methods: Patients diagnosed with primary lung cancer between 2014-2016 were included in the study. The patients were divided into two groups who were radiologically detected as having lymphangitis carcinomatosa, and who were detected with no lymphangitis carcinomatosa at diagnosis. The demographic, clinical, radiologic, and survival data of the patients were recorded in both groups. The data of both grups were compared. The data of the groups were evaluated using the Chi-square and Mann-Whitney U test and p<0.05 was considered as significant. Results: A total of 319 patients were included in the study. 264 (82.2%) of the cases were male and 55 (17.8%) were female. The mean age of the patients was 61.9±9.6. The average smoking history was 39.1±17.3 pack-years. 28 patients (8.8%) were diagnosed with LC, and 291 (91.2%) were not detected LC. When tumor histopathology of the cases were examined, the most common tumor type squamous cell carcinoma was found in both groups. No difference was detected in the characteristics of the patients diagnosed with LC, and of the patients diagnosed with no LC (Histopathologic diagnosis, stage, surgical/oncologic treatment features, history of smoking, age, and sex). The median general survival times in lung cancers detected with LC (11 months) were very similar particularly with the stage 3B (12 months) cancers with no LC (p=0.524). Conclusion: Lymphangitis carcinomatosa which is known to poorly affect the survival and prognosis, affects the survival in lung cancers. Therefore, LC must be considered in the staging of lung cancer.

Keywords: Lung neoplasms; lymphangitis; survival
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