SURGICAL TREATMENT AS A STAGE OF COMBINATION THERAPY FOR NON-SMALL CELL LUNG CANCER (NSCLC)
The purpose of the publication is to reflect the results of combined treatment of NSCC, complications of surgical treatment, pathomorphosis of the tumor and lymph nodes after neoadjuvant chemotherapy. The paper analyzes the immediate results of surgical treatment of 48 patients with non-small cell lung cancer after neoadjuvant treatment (drug or chemoradiotherapy). The N-status was determined based on the results of computed tomography, PET - CT, morphological analysis, followed by pathomorphological examination of the lymph nodes removed during the operation. The presence of therapeutic pathomorphosis of the tumor was detected in 53.5% of cases. The immediate results of surgical treatment and the number of complications in the early postoperative period are presented. The postoperative mortality rate was 6.7%. The reliability of preoperative N-staging was evaluated. In 17 patients, N - 2 positive for PET - CT, metastases in the lymph nodes were detected only in 11 (64.7%), respectively, in 6 patients (35.3%), the result was false positive. All patients with a false positive N-2 status determined on PET-CT suffered from central squamous cell carcinoma, complicated to varying degrees by a pronounced inflammatory process in the lung tissue caused by obturation pneumonitis. Neoadjuvant treatment did not worsen the course of the postoperative period and did not affect the frequency of surgical complications. In determining the N - status of patients with NSCLC with inflammatory processes in the lung tissue, histological (or cytological) verification is necessary (EBUS, EUS, mediastinoscopy/videothoracoscopy).