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Thoracic Surgery

LUNG CANCER CENTER

  • One and half million people died of lung cancer in 2010 in the entire world and this shows that 19% of cancer mortalities is due to lung cancer. Approximately 150.000 new cancer cases are diagnosed each year in our country.
  • DIAGNOSIS: Unfortunately, there is not a laboratory examination directly indicating the lung cancer. Tissue samples must be received and analyzed by pathologists in order to diagnose the disease accurately, to stage and regulate the treatment.

PA lung graphy and Computerized thorax tomography (BT) is the first stage of diagnosis. Later, PET-BT may be taken to help doctors both to support and stage the diagnosis.

 

Methods to sample the primary tumor and lymph node;

  • Bronchoscopic biopsy/transbronchial fine-needle aspiration (TBIA) or both
  • Endobronchial ultrasound (EBUS) or endoesophagial (EUS) guided biopsy
  • Screening accompanied percutaneous (transthoracic) needle aspiration and biopsy
  • Biopsy with electromagnetic navigation bronchoscopy (EMN)
  • Peripheral lymph node or scalene biopsy
  • Biopsy with mediastinoscopy
  • Biopsy with mediastinoscopy
  • Biopsy with VATS

 

SURGERIC TREATMENT: Lung cancer is the cancer type leading to death the most in the world. Approximately one and a half million people die of lung cancer every year and this makes up 19% of the cancer fatalities. Early state lung cancer includes the Stage IA, IB, IIA, IIB. The primary treatment for clinic early stage (Stage IA-IIB) cases having sufficient pulmonary functions and without a serious medical comorbidity is the surgical resection and it is the method providing the highest curing possibility. This group of patients makes up 20-25% of the entire lung cancer cases and it is believed that the diagnosis of early state lung cancer will increase due to the scanning studies with low dose computerized tomography that has lately been started to be applied. The golden standard in the surgical treatment for patient with sufficient respiration capacity is lobectomy. Segmentecomy or wedge resection may be applied for patients with limited respiration capacity (T1a-b, N0, M0) provided that complete resection is applied. More comprehensive surgical resections may be required to acquire negative surgical limits (such as broncho-angioplastic surgery, bilobectomy, pneunectomy). Lobectomy/segmentectomy postoperative early recovery with video-assisted thoracic surgery (VATS) and low mobility may be applied with standard oncologic principals in experienced centers. Sublobar resections (segmentectomy/wedge resection) may be applied to peripherally localized tumors with the size of 2 cm or less when the nodule contains more than 50% ground-glass appearance in the adenocarcinoma in situ histology and when the doubling time of the tumor is more than 400 days. In all the resection ways and surgical approach options, systematic mediastinal/hilar lymph node dissection or sampling must be carried out.

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