Management and Surgical Outcomes of Concurrent Tuberculosis and Lung Cancer.
BackgroundConcurrent pulmonary tuberculosis (TB) and lung cancer are rarely encountered in Western countries; however, it is more common in developing countries. We aim to share the diagnostic and treatment approaches in this study.Materials and MethodsClinical files of all patients undergoing lung resection for non-small cell carcinoma with concurrent pulmonary TB between February 2006 and December 2012 were investigated retrospectively in terms of patient characteristics, operation methods, definite pathology and stage of tumor, postoperative treatment schemes, and associated complications.ResultsTB was detected in 17 (1.3%) of 1,266 operated carcinoma patients. Eleven had squamous cell carcinoma and six had adenocarcinoma. Mean age was 54.9 years. Two patients received anti-TB treatment preoperatively. Fifteen patients were given anti-TB treatment postoperatively, as soon as definite microbiological confirmation was obtained, and concurrently given adjuvant therapy after 3 weeks of sole four-drug TB treatment. Pneumonectomy was performed in four (23.5%), sleeve lobectomy in three (17.6%), lobectomy in eight (47%), and bilobectomy in two (11.7%) patients. Postoperative complications occurred in four (23.5%) patients, with bronchopleural fistula being seen in only one pneumonectomy patient. No postoperative mortality or reactivation of TB was seen. Mean survival time was 32 ± 2 months.ConclusionResection following a 3-week anti-TB treatment or concurrent anti-TB and postoperative adjuvant chemotherapy does not constitute an additional postoperative risk for patients with concomitant lung malignancy and pulmonary TB. The determination of optimum treatment for these patients presents a challenge in developing countries, where TB is still a common disease.
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Serdar
S
Evman
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Volkan
V
Baysungur
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Levent
L
Alpay
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Bahadir
B
Uskul
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Aysun Kosif
AK
Misirlioglu
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Serda
S
Kanbur
Department of Thoracic Surgery, Süreyyapaşa Training and Research Hospital, Istanbul, Turkey.
Talha
T
Dogruyol
D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology
D000995:Antitubercular Agents