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Læknablaðið - 15.04.2010, Page 25

Læknablaðið - 15.04.2010, Page 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 >- DC < 2 5 D tfí 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 ENGLISH

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