Uticaj preoperativnih faktora i primenjene operativne procedure na incidencu i mogućnosti lečenja recidiva nesitnoćelijskog karcinoma pluća
Impact of preoperative factors and surgical treatment on incidence and treatment options in non-smal cell lung carcinoma local recurrence
Author
Stojiljković, Dejan V.Mentor
Mandarić, DraganCommittee members
Džodić, Radan
Đukić, Vladimir

Subotić, Dragan
Golubičić, Ivana
Metadata
Show full item recordAbstract
UVOD: Cilj ovog rada bio je, pre svega, praćenje učestalosti i vremena do pojave recidiva
nesitnoćelijskog karcinoma pluća tokom 5 godina po završenoj kompletnoj onkološkoj
terapiji, a kod posebno definisanih grupa bolesnika. U toku istraživanja ispitivani su
prognostički parametri značajni za razvoj lokalnog recidiva i njegovu operabilnost, sa
namerom definisanja kriterijuma za selekciju bolesnika podobnih za naknadni operativni
zahvat.
MATERIJAL I METODE: Ovom retrospektivno – prospektivnom studijom obuhvaćeno
je 114 bolesnika sa recidivom nesitnoćelijskog karcinoma pluća kliničkog stadijuma od Ia
do IV, operisanih u periodu od 2002. do 2010. godine. Korišćene su baze podataka Instituta
za plućne bolesti Kliničkog centra Srbije i Instituta za onkologiju i radiologiju Srbije u
Beogradu. Bolesnici su tokom pet godina praćeni imaging procedurama i bronhološki.
Recidivi su verifikovani patohistološki nekom od invazivnih dijagnostičkih metoda ili
radikalnom hirurškom intervencijom. Za odr...eđivanje stadijuma bolesti korišćena je klinička
i patohistološka TNM klasifikacija iz 2004.g. Statistička analiza je obuhvatila metode
deskriptivne i analitičke statistike, sa nivoom statističke značajnosti od α=0.05.
REZULTATI: U našem istraživanju, bolesnici sa recidivom bili su uglavnom muškog
pola, starosti oko 58 godina. Svi lokalni recidivi javili su se unutar 4 godine od operacije
primarnog tumora, sa medijanom od 13 meseci. Najčešća lokalizacija recidiva bio je zid
grudnog koša. Patohistološki, najzastupljeniji su bili skvamocelularni karcinomi umereno
diferentovanog gradusa. Značajno duže vreme do pojave recidiva zabeleženo je u grupi
pacijenata kod kojih su učinjene lobektomije ili bilobektomije u odnosu na ostale operacije.
Pokazana je statistički značajna razlika u vremenu do pojave i učestalosti recidiva tokom
prve dve godine od operacije primarnog tumora u odnosu na njegov stadijum i veličinu tumora kao nezavisnog prognostičkog faktora...
PURPOSE: The primary aim of this study was 5-years follow-up of incidence and time to
relapse after complete oncological treatment of non-small cell lung carcinoma, in precisely
defined groups of patients. In addition, prognostic parameters significant for local disease
recurrence and its operability were analyzed, with intent to define criteria for selection of
patients eligible for additional surgery.
METHODS: This retrospective - prospective study included 114 patients with recurrent
non-small cell lung carcinoma in clinical stages Ia to IV, operated from year 2002 to 2010.
Database of Institute for Lung Diseases, Clinical Center of Serbia and Institute for
Oncology and Radiology of Serbia, Belgrade were used. Patients were followed up for five
years using imaging procedures and bronchoscopy. Recurrences were verified
pathologically with one of the invasive diagnostic methods or radical surgical intervention.
Clinical and pathological TNM 2004 classification was used in determinatio...n of disease
stage. Statistical analysis included descriptive and analytical methods, with the significance
level of α = -0.05.
RESULTS: In our research, patients with recurrences were mainly male, aged
approximately 58 years. All local recurrences were reported within four years after primary
tumor surgery, with a median of 13 months. The most frequent localization of local
recurrences was the chest wall. Pathologically, the most common tumors were moderately
differentiated squamous cell carcinomas. Significantly longer time to relapse was observed
in the group of patients who underwent a lobectomy or bilobectomy, in comparison to other
surgical procedures. There was statistically significant difference in time to recurrence and
frequency of relapses during the first two postoperative years in relation to primary tumor stage and size as an independent prognostic factor...