Læknablaðið - 15.04.2004, Blaðsíða 35

FRÆÐIGREINAR / NÝR DOKTOR
Nýr doktor í
brjóstholsskurðlækningum
Þann 22. maí síðastliðinn varði Gunnar Mýrdal
brjóstholsskurðlæknir doktorsritgerð við læknadeild
háskólans í Uppsölum í Svíþjóð. Ritgerðin ber nafnið
Lung Cancer; Epidemilogical and Clinical Studies
with Special Reference to Surgical Treatment. And-
mælandi við doktorsvörnina var Bengt Bergman pró-
fessor í Gautaborg. Leiðbeinendur voru Elisabeth
Stáhle við háskólasjúkrahúsið í Uppsölum og Mats
Lambe við faraldsfræðideild háskólasjúkrahússins i
Stokkhólmi.
Hér á eftir fer útdráttur úr ritgerðinni á ensku.
From being a rare disease in the early 1900s, lung
cancer is today the most common form of cancer
worldwide. This development is due to the gradual
uptake of cigarette smoking in different populations
and birth cohorts during the past 75 years. In spite of
different modes of treatment, survival is still poor
and surgery remains the prerequisite for cure.
National data from the Swedish Cancer Register
for the 35-year period 1958-1994 were analysed to
estimate the effects of birth cohort, year of diagnosis
(period) and age at diagnosis on the time trends in
lung cancers. Early mortality, major morbidity during
the first 30 days, quality of life and long-term survival
after lung cancer surgery were assessed to estimate
the significance of pre-surgical and tumour-related
risk factors. Also, effects of delay in treatment among
patients with non-small cell lung cancer were
examined.
The main results indicate that the overall age-
adjusted incidence of lung cancer in Sweden has
stabilised in men during the last two decades but has
been increasing continuously in women. The fastest
rate increase was noted among the youngest women
and the incidence of adenocarcinoma is increasing in
both sexes. Our results show low early mortality and
morbidity after lung cancer surgery. Furthermore,
quality of life was comparable with that of CABG
patients postoperatively. However, patients with
reduced lung capacity and those undergoing pneu-
monectomy should be treated with great care, as they
run a considerable risk of major complications, im-
paired quality of life or death during the first 30 days
postoperatively. Tumour stage (TNM) is the best
prognostic indicator for long-term survival following
complete surgery, underlying the importance of
accurate surgical staging. Factors such as impaired
preoperative lung function, older age, and major
complications after surgery all negatively influence
survival. Current smokers as a group run a significant
risk of an adverse outcome (major complication or
death), impaired mental health and shortened
survival after lung cancer surgery. Waiting time for
treatment of lung cancer was longer than recom-
mended; especially among those surgically treated.
Shorter delay was associated with poorer prognosis
which is likely to indicate that patients with severe
symptoms and signs (advanced disease) receive
prompt treatment.
Gunnar lauk námi í læknadeild Háskóla Islands 1991
og hlaut sérfræðiréttindi í almennum skurðlækning-
um 1998 og í bijóstholsskurðlækningum árið 2000.
Gunnar starfar nú sem sérfræðingur í hjarta- og
lungnaskurðlækningum við háskólasjúkrahúsið í Upp-
sölum.
Dr. Gutmar Mýrdal.
irmar.
Læknablaðið 2004/90 315