RESUMEN
Background: In this study, we aimed to evaluate the effects of the transition from the 6th edition of the Tumor, Node, Metastasis (TNM) staging system to the 7th edition, and from the 7th edition to the 8th edition by comparing the stage migrations. We also aimed to externally validate the 8th edition of the TNM staging system. Methods: Between September 2005 and June 2015, a total of 1,077 patients (986 males, 91 females; mean age: 59.6±8.3 years; range, 35 to 84 years) with non-small cell lung cancer who underwent lung resection were retrospectively analyzed. We re-staged patients according to 6th, 7th, and 8th TNM staging and compared the stage migrations of cases among the three staging systems. Results: Stage migration in the transition to the 7th edition of the TNM staging system was observed in 368 (34.1%) patients whereas it was observed in 541 (50.2%) patients in the transition to the 8th edition (p<0.001). The rate of upstaging in transition to the 7th edition staging system was 50.2% (n=185), whereas it was 98.1% (n=531) for the transition to the 8th edition (p<0.001). The survival rates of Stages 1B, 2B and 3A increased with transition to the 7th edition and the survival rates of Stages 1B, 2A, 2B, 3A, and 3B increased with the transition to the 8th edition. The best stratification in the survival curves in the 6th edition was between 1B-1A and 3B-3A. In the 7th edition, it occurred between 1B-1A, 3A-2B and 3B-3A and, in the 8th edition, between 1B-1A and 3B-3A. Conclusion: Stratification according to the 7th edition showed better prognostic validity compared to the 6th edition; and that of the 8th edition was better compared to the 7th edition.
RESUMEN
OBJECTIVES: Hamartomas are common benign tumors of the lung. Rarely, lung cancer coincidence may occur at the time of diagnosis or in the follow-up period. METHODS: Between 2016 and 2019, 38 patients who underwent a surgical procedure and diagnosed with lung hamartoma were retrospectively evaluated regarding clinicopathological features. Cases were analyzed according to age, sex, radiological findings, localization of nodules, surgical methods, and the coincidence of lung cancer. RESULTS: The mean age was 50.2±11.1 (range 28-76 years). There were 23 male (60.5%) and 15 female (39.5%) patients. Mean size was 2.7±1.8 (range 0.8-10 cm). In 28 patients, hamartoma was <3 cm in diameter (73.6%). Eighteen hamartomas were localized in the upper lobe (47.4%). Only 6 cases (15.8%) were localized at the central part of the lung. Multiple nodules were reported in 10 cases (26.3%). In 4 cases (10.5%), lung carcinoma and hamartoma were seen together at the time of diagnosis. Video-assisted thoracoscopic surgery (VATS) has been performed in 29 cases (76.3%). As a surgical method, enucleation was performed in 4 cases (10.5%), wedge resection in 28 cases (73.7%), and lobectomy in 6 cases (15.8%). No post-operative mortality appeared in the early follow-up. CONCLUSION: Pulmonary hamartomas are usually present as solitary pulmonary nodules with benign radiological findings. VATS wedge resection is a method that can be used safely in diagnosis and treatment. Hamartomas may be associated with lung cancer at the time of diagnosis or follow-up, so it should be kept in mind that a different nodule seen in patients diagnosed with hamartoma may be associated with lung cancer.