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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
Supervisors
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.
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.
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.
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.
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