[Surgical treatment of lung carcinoma in tuberculosis patients]

Objective of our study was to analyze the cases of coexistent pulmonary tuberculosis and lung cancer.

During 1990-2002, 2218 patients with lung cancer were operated in Republic Santariskiu Tuberculosis and Lung Diseases Hospital and the Department of Thoracic Surgery and Oncology at the Institute of Oncology of Vilnius University.

Forty-six (2.1%) patients were diagnosed lung cancer and tuberculosis-associated pathology. By stages patients were divided into: I(st)stage - 12 patients (26.1%), II(nd)stage - 11 patients (23%), IIIA stage - 23 patients (50%). In 37 cases (80.4%) central tumor type was found, and in 9 cases (19.6%) - peripheric type. According to morphology, in 24 (52.2%) patients squamous cell was found, in 10 (21.2%) patients - adenocarcinoma and in 12 (26.1%) patients - mixed adenosquamous tumors. All these 46 patients were operated on: pneumectomy was performed for 18 (39.2%) patients, lobectomy - for 10 (21.7%) patients, bilobectomy - for 10 (21.7%) patients, and segmentectomy - for 8 (17.4%) patients. Six (21.4%) patients deceased. The development of cancer on site of previous active tuberculosis and residence metatuberculosis changes was evident. This shows the importance of the control strategy of patients with tuberculosis.

Coexistence of lung cancer and tuberculosis is very rare. Out of 2218 patients, operated on due to lung cancer, this pathology was diagnosed to 46 (2.1%). Squamous cell cancer was found in 52% and stage IIIA was observed in 50% of cases. Postoperative complications occurred in 28 (80%) patients, and 6 (28%) patients died. Crucial treatment method of lung cancer in tuberculosis patients is surgery. Average survival of these patients was 28+/-2 months.