The role of the multidisciplinary approach in locally advanced lung cancer: Retrospective analysis

Introduction and Aim: Lung cancer is one of the leading cancer-related deaths in our country much like the rest of the world. The treatment plan is determined according to the stage of the disease at the time of diagnosis and includes many treatment methods. Multidisciplinary councils are meetings where different specialties work together and clinical opinions are shared in the management of the disease. Lung cancer treatment in our hospital is managed by a multidisciplinary council. The purpose of this thesis is; to determine the effect of the council in the management of patients by analyzing the results of patients with non-small cell lung cancer, which are evaluated and treated according to the decision of the council. Method: Demographic-clinical data, treatment plan and results of 1771 patients who were evaluated at Bursa Uludag University Medical Faculty Weekly Multidisciplinary Thoracic Oncology Council between May 2015 and November 2019 were recorded. Nonpulmonary tumor patients and patients with small cell lung carcinoma were excluded from the study. 769 patients with non-small cell lung cancer were included in the study and the treatments applied to the patients, their results and survival were analyzed. Results: Clinically, 291 of the patients were early stage and 478 were advanced. Surgery was applied to %86.5 of early stage patients. Segmentectomy was performed in 25 (%9.3) patients, lobectomy in 180 (%67.1) and pneumonectomy in 6 (%2.2) patients. Mortality was seen in one patient and morbidity in 70 (%24) patients. Five-year survival was %64,1. Surgery was applied to 47% of advanced stage patients. 78.8% of these patients were after neoadjuvant therapy. The rate of disease progression was %2.4 in patients who received neoadjuvant therapy, and the rate of patients who underwent surgery was 88.1%. Segmentectomy was performed in 14 (%6.1) patients, lobectomy in 169 (%74.1), and pneumonectomy in 20 (%8.7). Mortality was detected in one patient and morbidity in 84 (%17.5) patients. Five-year survival was %38,6. Conclusion: Neoadjuvant therapy in advanced stage lung cancer managed by a multidisciplinary council is a safe approach with low progression, low mortality and morbidity rates.