UTERİN SERÖZ KARSİNOM VE UTERİN BERRAK HÜCRELİ KARSİNOM TANISI ALAN HASTALARDA KLİNİKOPATOLOJİK ÖZELLİKLERİN VE SAĞ KALIM SONUÇLARININ KARŞILAŞTIRILMASI Comparison Of Clinicopathologic Characteristics And Survivals In Patients With Uterine Serous And Clear Cell Carcinoma
Abstract
ÖZET
Amaç: Uterin seröz karsinom (USK) ve uterin berrak hücreli karsinomların (UBHK) klinikopatolojik özelliklerinin
ve hastaların sağ kalım sonuçlarının karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Final patoloji raporlarına göre, USK ve UBHK tanısı alan hastalar çalışma grubunu oluşturmaktadır.
Demografik, kilnikopatolojik ve sağkalım verileri analiz edildi.
Bulgular: USK grubunda 69 ve UBHK grubunda 36 hasta analiz edildi. USK grubunda hastaların UBHK grubundaki
hastalarla karşılaştırıldığında, istatistiksel olarak anlamlı derecede daha ileri evre hastalığı sahip olduğu
saptandı (sırasıyla %61,1 ve %36,2, p=0.015). USK grubundaki hastaların UBHK grubundaki hastalar ile
karşılaştırıldığında daha fazla omental metastaza (17/69 ve 2/36, p=0,016) ve peritoneal sitoloji pozitifliğine
(25/69 ve 5/36, p=0,016) sahip olduğu bulundu. Tüm kohort için multivaryan analizde sadece peritoneal sitoloji
pozitifliğinin azalmış hastalıksız sağkalım (DFS) için bağımsız risk faktörü olduğu bulundu (HR 5,07 95%
CI 2,07-12,42; p<0,001). Tüm kohort için, multivaryan analizde sadece peritoneal sitolojinin pozitif olması
azalmış kaba sağkalım (OS) için bağımsız risk faktörü olarak bulundu (HR 3,50 95% CI 1,31-9,33; p=0,012).
Sonuç: Sonuç olarak çalışmamızda USK ve UBHK tanısı alan hastalarda sitoloji pozitifliğini hem DFS hem de
OS için bağımsız prognostik faktör olarak saptadık. Ayrıca USK grubundaki hastalarda omental metastaz
oranlarının yüksek olması nedeniyle omentektominin cerrahi evrelemenin bir komponenti olması gerektiğini
düşünmekteyiz.
Anahtar kelimeler: Endometriyal karsinom; Uterin berrak hücreli karsinom; Uterin seröz karsinom.
ABSTRACT
Aim: We aimed to compare the clinicopathological characteristics and survivals between uterine serous
carcinoma (USC) and uterine clear cell carcinoma (UCCC).
Materials and Methods: The study population consists of women who were diagnosed with USC and UCCC
according to the final pathology reports. Demographic, clinicopathological and survival data were collected
and analyzed.
Results: A total of 69 patients with USC and 36 patients with UCCC were included in the final analysis.
Patients in the USC group tend to have more advanced stage disease compared to the patients in the UCCC
group and this was statistically significant between the groups (61.1% vs 36.2%, respectively; p=0.015).
Patients with USC were more likely to have omental metastasis (17/69 vs 2/36, p=0.016) and positive
peritoneal cytology (25/69 vs 5/36, p=0.016). In the multivariate analysis, only positive peritoneal cytology
remained as an independent prognostic factor for decreased disease free survival (DFS) for the entire cohort
(HR 5.07, 95% CI 2.07-12.42; p<0.001). Only positive peritoneal cytology was an independent prognostic
factor for decreased overall survival (OS) for the entire cohort (HR 3.50, 95% CI 1.31-9.33; p=0.012) in the
multivariate analysis.
Conclusion: We concluded that positive peritoneal cytology was an independent prognostic factor for
both DFS and OS in patients with USC and UCCC in the current study. Because of the high rate of omental
metastasis in the USC group, we also suggest performing an omentectomy as a part of the comprehensive
surgical staging surgery.
Key words: Endometrial carcinoma; Uterine clear cell carcinoma; Uterine serous carcinoma
References
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Abstract
References
- 1. Creasman WT, Ali S, Mutch DG, Zaino RJ, Powell MA, Mannel RS, et al. Surgical-pathological findings in type 1 and 2 endometrial cancer: An NRG Oncology/Gynecologic Oncology Group study on GOG-210 protocol. Gynecol Oncol. 2017;145(3):519-25. 2. Hamilton CA, Cheung MK, Osann K, Chen L, Teng NN, Longacre TA, et al. Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94(5):642-6. 3. Fader AN, Boruta D, Olawaiye AB, Gehrig PA. Uterine papillary serous carcinoma: epidemiology, pathogenesis and management. Curr Opin Obstet Gynecol. 2010;22(1):21-9. 4. Gadducci A, Cosio S, Spirito N, Cionini L. Clear cell carcinoma of the endometrium: a biological and clinical enigma. Anticancer Res. 2010;30(4):1327-34. 5. Mattes MD, Lee JC, Metzger DJ, Ashamalla H, Katsoulakis E. The incidence of pelvic and para-aortic lymph node metastasis in uterine papillary serous and clear cell carcinoma according to the SEER registry. J Gynecol Oncol. 2015;26(1):19-24. 6. Vogel TJ, Knickerbocker A, Shah CA, Schiff MA, Isacson C, Garcia RL, et al. An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers. J Gynecol Oncol. 2015;26(1):25-31. 7. Cancer Genome Atlas Research N, Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67-73. 8. Creasman WT, Odicino F, Maisonneuve P, Quinn MA, Beller U, Benedet JL, et al. Carcinoma of the corpus uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006;95 Suppl 1:S105-43. 9. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105(2):103-4. 10. Chan JK, Loizzi V, Youssef M, Osann K, Rutgers J, Vasilev SA, et al. Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium. Gynecol Oncol. 2003;90(1):181-5.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | March 25, 2020 |
| Published in Issue | Year 2020 Volume: 10 Issue: 1 |