Khodak A. The efficiency of systematic mediastinal lymph dissection in patients with lung cancer.

The dissertation is dedicated to studying the efficiency of mediastinal lymph dissection in treatment of patients with lung cancer, and it is based on a complex estimation of clinical, pathomorphological, molecular and biological data. With the purpose of increase of radicalism in patients with lung cancer systematic mediastinal lymph dissection has been done. Performance of systematic mediastinal lymph dissection has not influenced the structure of postoperative complications, however it is accompanied by rise in cardiac rhythm disturbance, and it increases probability of pleural empyema. The study of the removed lymph nodes by means of monoclonal antibodies to cytokeratins has allowed to reveal additionally in 21 % of patients cancer metastasises that confirms the expediency of obligatory performance of mediastinal lymph dissection. In 28,6 % patients with lung cancer who underwent the radical operations, single cancer cells in bone marrow have been found by means of light microscopy and monoclonalantibodies to cytokeratins. Studying of the remote results in treatment of patients with lung cancer has shown significant decrease in frequency of intrathoracic relapses in patients who underwent systematic mediastinal lymph dissection, and probable increase of 3-year survival rate from 47,6 % up to 62,9 % has been established. It is established, that presence of single cancer cells in a bone marrow is a poor prognostic factor as all patients in whom they have been found have died in the first 3 years after operation. Researching resuits adoption has been realized on the bases of several oncological clinics and Kharkiv National Medical University. Results received can be used in practice of everyday work for oncologists, as well as for lecture material for the oncological department students, oncological doctors postgraduate programmes.