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Tesi etd-06182014-122441


Thesis type
Tesi di specializzazione (5 anni)
Author
ZIRAFA, CARMELINA
URN
etd-06182014-122441
Title
Carcinoma polmonare con diffusione extrascissurale: prognosi e valutazione del ruolo della chemioterapia adiuvante
Struttura
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Corso di studi
CHIRURGIA TORACICA
Commissione
relatore Prof. Mussi, Alfredo
Parole chiave
  • neoplasia polmonare
  • scissura
  • chirurgia
  • chemioterapia
Data inizio appello
04/07/2014;
Consultabilità
completa
Riassunto analitico
Despite lung cancer invading the fissure to the adjacent lobe is classified T2 according to the 7th edition TNM, it has a prognosis similar to T3. The aim of our study is to evaluate the prognosis of NSCLC invading interlobar fissure in relation to its treatment.<br>Clinical records of 34 patients who underwent surgery from February 2006 to December 2010 for NSCLC with interlobar fissure involvement were retrospectively analyzed. Patients who underwent neoadjuvant chemotherapy, N2-N3 disease, separate tumor nodule in same or different lobe, broncho-vascular sleeve resections were excluded. <br>Surgical procedures consisted in 19 lobectomies enlarged to adjacent lobe (Group A), 7 pneumonectomies and 8 bilobectomies (Group B). On a mean follow-up period of 68,5 months, local recurrence was experienced in 3 patients (15,8%) of the group A and in one patient of group B, while systemic metastasis occurred respectively in 9 patients (47,4%) and in 7 patients (46,6%). At the follow-up 7 patients died from lung cancer, 2 out of them received chemotherapy . The 5-years disease free survival was 43% and the disease specific survival was 66%. No statistically significant difference was found between the surgical groups.<br>Although the patients treated with non-anatomical resection present an higher local recurrence rate, the 5-years disease specific survival is similar to patients undergoing anatomical resection. Our results suggest that non-anatomical resections, associated with chemotherapy, represent a feasible surgical option in patients with NSCLC invading fissure.<br>
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