Endometrium kanserli olgularımızın klinik, patolojik ve tedavi özelliklerinin gözden geçirilmesi
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Endometrium kanserleri kadın kanserleri arasında %4.8 görülme oranı ile 6. sıradadır. Kadın genital sisteminin gelişmiş ülkelerde en sık görülen malign tümörüdür. Nispeten sıklıkla görülen bu malignite için yaptığımız çalışmada; 1997-2015 yılları arasında Trakya Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı'na başvuran endometrium kanserli hastaların dosyaları retrospektif olarak incelenerek, demografik özelliklerin, tedavi tiplerinin, histopatolojik özelliklerin ve prognostik faktörlerin araştırılması amaçlandı. Hastaların %81.6'sının postmenopozal dönemde tanı aldığı ve %68.3'ünün evre I olduğu belirlendi. Tanı anında 6 (%4.4) hastada metastaz tespit edildi. İzlem süresince 9 (%6.6) hastada nüks geliştiği belirlendi. Hastaların medyan genel sağ kalım süresi 193 ay olarak bulundu. Prognostik faktörler üzerine yaptığımız tek değişkenli analizde hastalığın evresi, histolojik derecesi, tanı yaşı, histolojik tip, lenf nodu metastazı varlığı, lenfatik ve vasküler invazyon varlığı, myometrial invazyon derinliği, servikal stromal invazyon varlığı, tümör çapı, periton sitolojisi pozitifliği, serum CA-125 düzeyi ve hemoglobin düzeyinin genel sağ kalımı anlamlı düzeyde (p<0.05) etkilediği tespit edildi. Tanı yaşı, histolojik tip, lenfatik invazyon varlığı, tümör çapı, histolojik derece ve hemoglobin düzeyinin ise hastalıksız sağ kalımı anlamlı düzeyde (p<0.05) etkildeği tespit edildi. Çok değişkenli analizde evre ve pre-operatif CA-125 düzeyinin genel sağ kalımı belirlemede, tek başına evrenin ise hastalıksız sağ kalımı belirlemede bağımsız prognostik faktörler olduğu belirlendi (p<0.05). Sonuç olarak; hastalığın prognozu üzerine en etkili faktörün hastalığın evresi olduğu kanaatindeyiz. Evre dışında tespit ettiğimiz diğer prognostik faktörlerin adjuvan tedavi kararı alınırken göz önünde bulundurulması açısından çok sayıda hasta içeriği bulunan prospektif çalışmalara ihtiyaç olduğunu düşünmekteyiz. Anahtar kelimeler: Endometrium kanseri, klinikopatoloji, prognostik faktörler
Endometrium cancer is the 6th common type of cancer among women cancers with %4.8 prevelance. It is the most common women genitelial system tumor in developed countries. In this study we investigated the files retrospectively and aimed to research for demographic features, treatment modalities, histopathological features and prognostic factors of endometrium cancer in patients who admitted to Trakya University Medical Faculty Medical Oncology Department between 1997-2015. %81.6 of the patients was diagnosed at postmenopausal period and %68.3 of the patients had stage 1 disease. In 6 patients (%4.4), metastasis was present at the time of diagnosis. Recurrence occured in 9 patients (%6.6) during the follow up period. The median survival of the patients was 193 months. As the results of our univariate analysis on prognostic factors, we found that stage of disease, histological degree, age at diagnosis, histological type, presence of lymph node metastasis, presence of lymphatic and vascular invasion, myometrial invasion depth, presence of servical stromal invasion, tumor diameter, positivity of periton sitology, serum CA-125 level and hemoglobin level affect the overall survival rate significantly (p<0.05). Also it was found that age at diagnosis, histological type, presence of lymphatic invasion, tumor diameter, histological degree and hemoglobin level affect the disease free survival significantly (p<0.05). In multivariate analysis, stage and pre-operative CA125 levels were found to be prognostic factors to determine the overall survival and stage alone found to be independent prognostic factor to determine the disease free survival (p<0.05). In conclusion; we think that stage of the disease is the most effective factor for prognosis. Also we think, to consider the other prognostic factors except for stage to make decision for adjuvant treatment, prospective studies including more patients are needed. Key words: Endometrium cancer, clinicopathology, prognostic factors
Endometrium cancer is the 6th common type of cancer among women cancers with %4.8 prevelance. It is the most common women genitelial system tumor in developed countries. In this study we investigated the files retrospectively and aimed to research for demographic features, treatment modalities, histopathological features and prognostic factors of endometrium cancer in patients who admitted to Trakya University Medical Faculty Medical Oncology Department between 1997-2015. %81.6 of the patients was diagnosed at postmenopausal period and %68.3 of the patients had stage 1 disease. In 6 patients (%4.4), metastasis was present at the time of diagnosis. Recurrence occured in 9 patients (%6.6) during the follow up period. The median survival of the patients was 193 months. As the results of our univariate analysis on prognostic factors, we found that stage of disease, histological degree, age at diagnosis, histological type, presence of lymph node metastasis, presence of lymphatic and vascular invasion, myometrial invasion depth, presence of servical stromal invasion, tumor diameter, positivity of periton sitology, serum CA-125 level and hemoglobin level affect the overall survival rate significantly (p<0.05). Also it was found that age at diagnosis, histological type, presence of lymphatic invasion, tumor diameter, histological degree and hemoglobin level affect the disease free survival significantly (p<0.05). In multivariate analysis, stage and pre-operative CA125 levels were found to be prognostic factors to determine the overall survival and stage alone found to be independent prognostic factor to determine the disease free survival (p<0.05). In conclusion; we think that stage of the disease is the most effective factor for prognosis. Also we think, to consider the other prognostic factors except for stage to make decision for adjuvant treatment, prospective studies including more patients are needed. Key words: Endometrium cancer, clinicopathology, prognostic factors
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Onkoloji, Oncology
