The Use of Surgical Method in Lung Cancer Staging and its Impact on Selection of Treatment in ۱۰۰ Patients with Lung Cancer in Imam Khomeini Hospital of Tabriz

Background and Objective: Lung cancer is the leading cancer killer and is the second most frequently diagnosed cancer behind prostate in men and breast cancer in women. Staging has a very important role in determination of disease extension and therefore in deciding about the kind of treatment. The aim of this study is showing the effect of surgical method in lung cancer staging and its impact on selection of treatment in patients with lung cancer. Materials and Methods: In this study (case series) ۱۰۰ in-patients diagnosed to be suffering from lung cancer in the thorax ward of Tabriz Imam Khomeini Hospital were studied in the course of two years. In the first place, a highly precise history was taken from every in-patient diagnosed to be suffering from lung cancer in the thorax ward. They were, then, examined thoroughly and all of the symptoms and signs were recorded. Paraclinical studies were started with chest x ray. Mediastinoscopy, Mediastinotomy, Thoracoscopy, Thoracotomy, cervical lymph node biopsy or pleural fluid tap for precise staging were performed if indicated. After recording all the results in a questionnaire, we started the processes of staging of the disease. After that, the most appropriate decisions with regard to the treatment of the disease were made. Results: In this study ۶۷ people (۶۷%) were male and ۳۳ people (۳۳%) were female. Stages of lung cancer were done by surgical and non surgical methods in the patients studied. Different stages of the disease were found to be SIA ۳%, SIB ۲۵%, SIIA ۱%, SIIB ۷%, SIIIA ۱۵%, SIIIB ۲۳%, and SIV ۲۶%. Conclusion: In this study, the use of surgical methods played a major role in exact staging of lung cancer and treatment protocol was changed in ۲۹% of patients and also showed that, the use of surgical method improves the accuracy of the staging and therefore can extremely affect the kind of treatment in the patients with lung cancer. References ۱- Shields Tw, LoCicero J, Reed CE, Feins RH. Genral thoracic surgery. Seventh edition. Philadelphia, USA: Lippincott William and Wilkins ۲۰۰۹. ۲- Alexander Patterson G, Griffith Pearson F, Cooper JD, et al. Pearsonchr('۳۹')s thoracic surgery and esophageal surgery. Thirth edition. Philadelphia: Churchill Livingstone ۲۰۰۸. ۳- Naidoo R, Windsor MN, Goldstraw P. Surgery in ۲۰۱۳ and beyond. J Thorac Dis. ۲۰۱۳ ۵: ۵۹۳-۶۰۶. ۴- Brunicardi FC, Andersen Dk, Billiar TR, et al. Schwartzchr('۳۹')s principles of surgery. Ninth edition. United States of America: McGraw-Hill companies ۲۰۱۰. ۵- Passlick B. Initial surgical staging of lung cancer. Lung cancer. ۲۰۰۳ ۴۲: ۲۱-۵. ۶- Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, ۳rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. ۲۰۱۳ ۱۴۳: ۲۷۸-۳۱۳. ۷- Taghipour Zahir S, Mirtalebi M. Survival of patients with lung cancer, Yazd, Iran. Asian Pacific J Cancer Prev. ۲۰۱۲ ۱۳: ۴۳۸۷-۹۱. ۸- Noronha V, Dikshit R, Raut N, et al. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer. ۲۰۱۲ ۴۹: ۷۴-۸۱. ۹- Alamoudi OS. Lung cancer at a university hospital in Saudi Arabia: a four-year prospective study of clinical, pathological, radiological, bronchoscopic, and biochemical parameters. Ann Thorac Med. ۲۰۱۰ ۵: ۳۰-۶. ۱۰- Rawat J, Sindhwani G, Gaur D, et al. Clinico-pathological profile of lung cancer in Uttarakhand. Lung India. ۲۰۰۹ ۲۶: ۷۴-۶. ۱۱- Santos-Martinez MJ, Curull V, Blanco ML, et al. Lung cancer at a university hospital: epidemiological and histological characteristics of a recent and a historical series. Arch Bronconeumol. ۲۰۰۵ ۴۱: ۳۰۷-۱۲. ۱۲- Sahin F, Yildiz P. Radiological, bronchoscopic and histopathologic characteristics of patients with primary lung cancer in Turkey (۲۰۰۶-۲۰۰۹). Asian Pac J Cancer Prev. ۲۰۱۱ ۱۲: ۱۹۴۷-۵۲. ۱۳- Hashemzadeh S, Hashemzadeh K. Epidemiological study of lung cancer in East Azerbaijan, Iran. J Cardivasc Thorac Res. ۲۰۰۹ ۱: ۷-۱۲. ۱۴- Bhurgri Y, Bhurgri A, Usman A, et al. Patho-epidemiology of lung cancer in Karachi (۱۹۹۵-۲۰۰۲). Asian Pac J Cancer Prev. ۲۰۰۶ ۷: ۶۰-۴. ۱۵- Eggeling S, Martin T, Bottger J, et al. Invasive staging of non-small cell lung cancer-a prospective study. Eur J Cardiothorac Surg. ۲۰۰۲ ۲۲: ۶۷۹-۸۴. ۱۶- Wang X, Zheng L, Ling L, et al. Prospective comparison of CT versus mediastinoscopy in preoperative evaluation of mediastinal lymph node status in patients with non-small cell lung cancer. Zhonghua Zhong Liu Za Zhi. ۲۰۰۹ ۳۱: ۴۲-۴. ۱۷- Wang X, Zheng L, Zhang SY, et al. Risk factor analysis of mediastinal lymph node metastasis in non-small cell lung cancer patients and the strategy of mediastinoscopy prior to surgery. Zhonghua Zhong Liu Za Zhi. ۲۰۰۹ ۳۱: ۴۵۶-۹.

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Keyword: lung cancer , Staging , Surgical methods , Treatment