Evaluation of extended lung resection cases performed in Karadeniz Technical University Thoracic Surgery Clinic

Aims: Lung cancer is the most important cancer problem in today's world. Lung cancer-related deaths are in the fifth place among all deaths. 25-30% of cases diagnosed with lung cancer are detected in locally advanced stage. In recent years, improvement in survival times has been achieved with the increase in treatment possibilities and multimodal treatment options. The best method in the treatment of lung cancer is surgical treatment. A retrospective study was planned to evaluate our patients who underwent extended lung resection treatment in general. Materials and Methods: Sixty-one patients with locally advanced stage who were operated on with the diagnosis of Non-Small Cell Lung Cancer (NSCLC) in the Department of Thoracic Surgery of Karadeniz Technical University Faculty of Medicine between 2015 and 2019 were included in the study. The data of the patients were determined retrospectively from their medical records. Data include age, gender, comorbidities, symptoms, smoking status, pulmonary function test results, tumor localization, methods used for preoperative tissue diagnosis, histopathological cell type, surgical resection type, pathological stage, nodal involvement, postoperative complications, adjuvant therapy types and mortality rate. Survival and factors affecting survival were evaluated statistically. Results: When the data of the patients were analyzed, 14 (22.9%) patients were Stage ІІB, 40 (65.5%) patients were Stage IIIA, and 7 (11.4%) patients were Stage IIIB. The most common type of extended lung resection was intrapericardial pneumonectomy in 30 (49.1%) patients, followed by en-bloc resection of the chest wall in 21 (34.2%) patients. After pathological examinations, 36 (59%) patients had squamous cell carcinoma. During the pathological examination, 35 (57.4%) patients less than T4 and 26 (42.6%) patients with T4 were detected. In the postoperative period, chemotherapy (CT) was given to 31 (50.8%) patients, and chemoradiotherapy (CRT) was given to 24 (39.3%) patients. Although chemoradiotherapy was recommended to six (9.8%) patients, no additional treatment was given according to their wishes. In the survival analysis, 1-year survival was 63.9%, and the median survival time was 48 months. A statistically significant correlation was found between adjuvant CT and adjuvant CRT and survival (p=0.003). Finally, the mortality rate was 36.1%. Conclusion: Extended lung resection therapy provides significant contributions to the improvement of survival rates in locally advanced cases selected as a result of good evaluations. Especially with adjuvant chemotherapy, local recurrences can be prevented and survival can be increased.