İleri yaş akciğer kanserinde cerrahi tedavi sonuçları
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada, primer bronkojenik karsinom nedeniyle opere edilen 70 yaş ve üstü 24 hasta retrospektif olarak incelendi; sonuçlar aynı nedenle opere edilen 70 yaş altı 90 hasta ile karşılaştırıldı. Yaşları 70-86 arasında değişen grubun yaş ortalaması 74.6 ± 3.3 olup, 21 erkek ve üç kadın hastadan oluşmaktaydı. Tümör histolojisi, 16 (%67) hastada epidermoid karsinom, 6 (%25) hastada adenokarsinom, 2 (%8) hastada ise büyük hücreli karsinom şeklindeydi. Olguların 12'sinde operasyon riskini arttıran yandaş hastalık (altı koroner arter hastalığı ve/veya hipertansiyon, dört kronik obstrüktif akciğer hastalığı, iki diyabet) mevcuttu. En sık lobektomi (%67) ve sınırlı rezeksiyon (%25) uygulandı. Postoperatif olarak dokuz hasta evre l, dokuz hasta evre II, dört hasta evre IIIA, iki hasta ise evre IIIB olarak değerlendirildi. Üç (%13) hastada majör komplikasyon gelişti, postoperatif 30 günlük mortalite bir hasta ile %4 oranında gerçekleşti. Son iki parametre, 70 yaş altı hastalarda sırasıyla 10 (%11) olgu ve l (%1) olgu düzeyinde izlendi ve her iki gruptaki değerler arasında istatistiksel olarak anlamlı bir fark saptanmadı. Bu veriler ışığında, yaşlı hastalarda yapılan akciğer rezeksiyonunun morbidite ve mortalilesinin -doğru hasta seçimi yapıldığında ve postoperatif bakım yeterince uygulandığında- daha genç hastalardan yüksek olmadığı, dolayısıyla bu hastalarda da küratif rezeksiyon yapılması gerektiği sonucuna varıldı.
In this study, 24 patients aged 70 and over who were operated for primary bronchogenic carcinoma were reviewed retrospectively and their results were compared with those of 90 patients under 70, whom operated for the same intent. The mean age and age range of the group were 74.6 ± 3.3 and 70-86, respectively, and it consisted of 21 male and three female patients. The histology of the tumor revealed epidermoid carcinoma in 16 (67%) patients, adenocarcinoma in 6 (25%), and large cell carcinoma in 2 (8%). Twelve of the elderly patients had associated diseases (six had coronary artery disease and/or hypertension, four had chronic obstructive pulmonary disease and two had diabetes) that increased the operative risk. The resection type used most frequently was lobectomy (67%), followed by limited resection (25%). In postoperative staging, nine patients were found to have stage I disease, nine stage II disease, four stage IIIA disease and two stage IIIB disease. Three (13%) patients developed major complications, and postoperative mortality rate within 30 days was 4% with one patient. In the patients aged under 70, the last two variables were noted in 10 (%11) cases and in 1 (%1) case respectively, and the difference between the two groups was statistically insignificant. As a result, with appropriate patient selection and vigorous postoperative care, morbidity and mortality of the pulmonary resections in elderly is not higher than in young patients, and a curative resection should be preferred.
In this study, 24 patients aged 70 and over who were operated for primary bronchogenic carcinoma were reviewed retrospectively and their results were compared with those of 90 patients under 70, whom operated for the same intent. The mean age and age range of the group were 74.6 ± 3.3 and 70-86, respectively, and it consisted of 21 male and three female patients. The histology of the tumor revealed epidermoid carcinoma in 16 (67%) patients, adenocarcinoma in 6 (25%), and large cell carcinoma in 2 (8%). Twelve of the elderly patients had associated diseases (six had coronary artery disease and/or hypertension, four had chronic obstructive pulmonary disease and two had diabetes) that increased the operative risk. The resection type used most frequently was lobectomy (67%), followed by limited resection (25%). In postoperative staging, nine patients were found to have stage I disease, nine stage II disease, four stage IIIA disease and two stage IIIB disease. Three (13%) patients developed major complications, and postoperative mortality rate within 30 days was 4% with one patient. In the patients aged under 70, the last two variables were noted in 10 (%11) cases and in 1 (%1) case respectively, and the difference between the two groups was statistically insignificant. As a result, with appropriate patient selection and vigorous postoperative care, morbidity and mortality of the pulmonary resections in elderly is not higher than in young patients, and a curative resection should be preferred.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Solunum Sistemi
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Cilt
51
Sayı
3
