12. tbl. 95. árg. 2009
Fræðigrein
Árangur lungnabrottnámsaðgerða við lungnakrabbameini á Íslandi
Results of pneumonectomy for non-small cell lungcancer in Iceland
Ágrip
Inngangur
Efniviður og aðferðir
Áður en rannsóknin hófst lágu fyrir öll tilskilin leyfi frá Persónuvernd, Vísindasiðanefnd og framkvæmdastjóra lækninga á Landspítala.
Niðurstöður






Í lok rannsóknartímabils (20. febrúar 2009) reyndust 60 sjúklinganna látnir en 16 voru á lífi (sjúklingur með smáfrumukrabbamein ekki talinn með). Mynd 1 sýnir Kaplan-Meier graf yfir lífshorfur alls sjúklingahópsins og voru eins, þriggja og fimm ára lífshorfur 61,8% (95% öryggisbil 51,8-73,8%), 32,9% (23,6-48,0%) og 20,7% (12,7-33,6%). Lífshorfur fyrir sjúklinga sem greindust á stigi I-IIIA annars vegar og IIIB og IV hins vegar voru 24,0% og 12,1% eftir fimm ár (mynd 2), en munurinn reyndist marktækur (p=0,0097).
Umræður

Skammtímaárangur lungnabrottnámsaðgerða á árunum 1988-2007 var góður hér á landi og tíðni alvarlegra fylgikvilla lág. Langtímalífshorfur voru hins vegar lakari en í sambærilegum rannsóknum og aðeins einn af hverjum fimm sjúklingum á lífi fimm árum eftir aðgerð. Ófullnægjandi stigun sjúklinga fyrir skurðaðgerð er nærtækasta skýringin enda var tæpur þriðjungur sjúklinga á stigi IIIB eða IV við stigun eftir aðgerð. Ljóst er að bæta þarf stigun þessara sjúklinga hér á landi með því að fjölga miðmætisspeglunum og með staðlaðri notkun myndgreiningarrannsókna og nýrri stigunarrannsókna.
Þakkir
Heimildir
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