Læknablaðið - 15.04.2010, Side 25
FRÆÐIGREINAR
RANNSÓKN
5. Þorsteinsson H, Jónsson S, Alfreðsson H, ísaksson HJ,
Guðbjartsson T. Árangur lungnabrottnámsaðgerða við
lungnakrabbameini á íslandi. Læknablaðið 2009; 95:823-9.
6. Skúladóttir R, Óskarsdóttir GN, ísaksson HJ, Jónsson S,
Þorsteinsson H, Guðbjartsson T. Fylgikvillar blaðnáms-
aðgerða við lungnakrabbameini á íslandi 1999-2008.
Læknablaðið 2010; 96: 243-9.
7. Mountain CF. Revisions in the Intemational System for
Staging Lung Cancer. Chest 1997; 111:1710-7.
8. Dillman RO, Zusman DR, McClure SE. Surgical Resection
and Long-Term Survival for Octogenarians Who Undergo
Surgery for Non-Small-Cell Lung Cancer. Clin Lung Cancer
2009; 10:130-4.
9. Carretta A, Ciriaco P, Melloni G, et al. Surgical Treatment
of Multiple Primary Adenocarcinomas of the Lung. Thorac
Cardiovasc Surg 2009; 57: 30-4.
10. Fry WA, Menck HR, Winchester DP. The national cancer data
base report on lung cancer. Cancer 1996; 77:1947-55.
11. Mountain CF. Staging classification of lung cancer - A critical
evaluation. Clin Chest Med 2002; 23:103.
12. Sekine Y, Behnia M, Fujisawa T. Impact of COPD on
pulmonary survival of patients under complications and on
long-term going surgery for NSCLC. Lung Cancer 2002; 37:
95-101.
13. Schneider T, Pfannschmidt J, Muley T, et al. A retrospective
analysis of short and long-term survival after curative
pulmonary resection for lung cancer in elderly patients.
Lung Cancer 2008; 62: 221-7.
14. Riquet M, Foucault C, Berna P, Assouad J, Dujon A, Danei C.
Prognostic value of histology in resected lung cancer with
emphasis on the relevance of the adenocarcinoma subtyping.
Ann Thorac Surg 2006; 81:1988-95.
15. Detterbeck FC, Jantz MA, Wallace M, Vansteenkiste J,
Silvestri GA. Invasive mediastinal staging of lung cancer
- ACCP evidence-based clinical practice guidelines (2nd
edition). Chest 2007; 132: 202S-20S.
16. Toloza EM, Harpole L, Detterbeck F, McCrory DC. Invasive
staging of non-small cell lung cancer - A review of the current
evidence. Chest 2003; 123:157S-66S.
17. Nakamura H, Kawasaki N, Taguchi M, Kabasawa K.
Survival following lobectomy vs limited resection for stage I
lung cancer: a meta-analysis. Br J Cancer 2005; 92:1033-7.
18. Manser R, Wright G, Hart D, Byrnes G, Campbell D. Surgery
for early stage non-small cell lung cancer. Cochrane database
of systematic reviews 2005. www.mrw.interscience.wiley.
com/cochrane/clsysrev/articies/CD004699/frame.html.
19. Pisters Le C. Adjuvant chemotherapy in completely resected
non-small-cell lung cancer. J Clin Oncol 2008; 26: 2238.
20. De Leyn P, Lardinois D, Van Schil PE, et al. ESTS guidelines
for preoperative lymph node staging for non-small cell lung
cancer. Eur J Cardio-Thorac Surg 2007; 32:1-8.
21. Scagliotti GV. The ALPI trial: The Italian/European
experience with adjuvant chemotherapy in resectable non-
small lung cancer 2005: Amer Assoc Cancer Research.
22. Myrdal G, Lamberg K, Lambe M, Stahle E, Wagenius G,
Holmberg L. Regional differences in treatment and outcome
in non-small cell lung cancer: A population-based study
(Sweden). Lung Cancer 2009; 63:16-22.
23. Goya T, Asamura H, Yoshimura H, et al. Prognosis of 6644
resected non-small cell lung cancers in Japan: A Japanese
lung cancer registry study. Lung Cancer 2005; 50: 227-34.
24. Spiro SG, Gould MK, Colice GL. Initial evaluation of the
patient with lung cancer: Symptoms, signs, laboratory
tests, and paraneoplastic syndromes - ACCP evidenced-
based clinical practice guidelines (2nd edition). Chest 2007;
132:149S-60S.
25. Lyons G, Quadrelli S, Silva C, et al. Analysis of survival
in 400 surgically resected non-small cell lung carcinomas:
Towards a redefinition of the T factor. J Thorac Oncol 2008; 3:
989-93.
26. Sienel W, Dango S, Kirschbaum A, et al. Sublobar resections
in stage IA non-small cell lung cancer: segmentectomies
result in significantly better cancer-retated survival than
wedge resections. Eur J Cardiothorac Surg. 2008; 33: 728-34.
27. Brock MV, Kim MP, Hooker CM, et al. Pulmonary resection
in octogenarians with stage I nonsmall cell lung cancer. Ann
Thorac Surg. 2004; 77: 271-7.
28. Shen KR, Meyers BF, Lamer JM, Jones DR. Special treatment
issues in lung. cancer - ACCP evidence-based clinical
practice guidelines (2nd edition). Chest 2007; 132: 290S-305S.
29. Guðbjartsson T, Gyllstedt E, Pikwer A, Jonsson P. Early
surgical results after pneumonectomy for non-small cell lung
cancer are not affected by preoperative radiotherapy and
chemotherapy. Ann Thorac Surg 2008; 86: 376-82.
Factors predictive of survival after lobectomy for non-small
cell lung cancer in lceland during 1999-2008
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Oskarsdottir GN, SkuladoWr R, Thorsteinsson H, Isaksson HJ, Jonsson, Gudbjartsson T.
Factors predictive of survival after lobectomy for non-small cell lung cancer in lceland during 1999-2008.
lcelMed J 2010; 96:251-7.
Key words: Lung cancer, lobectomy, survival, prognostic factors, multivariate anatysis.
Correspondence: Tómas Guðbjartsson, tomasgud@landspitali.is
Objective: To study the impact of TNM stage and various
preoperative functional parameters on survival in patients
who underwent lobectomy for non-small cell lung cancer
(NSCLC) in lceland from 1999 to 2008.
Materials and methods: Retrospective study including
213 patients (mean age 66.9 yrs, equal male/female ratio)
that underwent lobectomy for NSCLC. Tumors were staged
by the TNM staging system, survival was estimated by the
Kaplan-Meier method and prognostic factors of survival
studied using the Cox proportional hazards regression
model.
Results: Survival at 1 year was 82.7% and 45.1 % at
5 years. Operative mortality at 30 days was 0%. Most
tumors were found to be in stage I (59.6%) or stage II
(17.8%) and 7% were stage IIIA, whereas 14.6% were
in stage IIIB or IV. Using multivariate analysis; advancing
stage, increasing tumor size, reduced lung function and
history of arrhythmia, predicted worse survival, whereas
adenocarcinoma histology was a positive prognostic factor
(HR 0.5, p=0.002) when compared to other histological
types.
Conclusions: Survival for patients undergoing lobectomy
for operable non-small cell lung cancer in lceland is
comparable with other studies. Advanced stage, tumor
size, reduced lung function and arrhythmia were negative
predictors of survival, but in contrast to many but not
all studies adenocarcinoma histology predicted a better
prognosis compared to other tumor types.
Barst: 4. október 2009, - samþykkt til birtingar: 25. janúar 2010
Hagsmunatengsl: Engin
LÆKNAblaðið 2010/96 257
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