Neoadjuvan Kemoterapi Alan Luminal Tip Meme Kanserli Hastalarda Patolojik Tam Yanıtı Predikte Eden Faktörler

Year 2023, Volume: 50 Issue: 2 - Cilt 50, Sayı 2, 269 - 276, 12.06.2023

Zuhat Urakçı Nadiye Akdeniz Sezai Tunç Zeynep Oruç Mehmet Küçüköner Muhammet Ali Kaplan Hüseyin Büyükbayram Abdurrahman Işıkdoğan

https://doi.org/10.5798/dicletip.1313421

Abstract

Amaç: Luminal tip meme kanserinde birçok çalışma yapılmış olmasına rağmen günümüzde bu tip meme kanserinde patolojik tam yanıtı (pCR) predikte eden faktörler halen net olarak bilinmemektedir. Bu çalışmamızda neoadjuvan kemoterapi alan luminal tip meme kanserli hastalarda patolojik tam yanıtı predikte eden faktörleri incelemeyi amaçladık.
Yöntemler: Çalışmaya Ocak 2010 ile Aralık 2018 arasında onkoloji merkezimizde neoadjuvan kemoterapi alan, luminal tip lokal ve lokal ileri evre meme kanserli, 18 yaşından büyük, 122 kadın hasta dahil edildi. Çalışmamızda neoadjuvan kemoterapi alan luminal tip meme kanseri tanılı hastalarda patolojik tam yanıtı predikte etme potansiyeli olan faktörleri retrospektif olarak inceledik.
Bulgular: Hastaların menopozal durumu (p=0.638), tümör lokalizasyonu (sağ-sol) (p=0.791) ve tümör boyutu (p=0.861) ile pCR arasında istatistiksel olarak anlamlı ilişki izlenmedi. Patolojik tam yanıt ile invaziv duktal karsinom histolojisine sahip olma (p=0.001), östrojen reseptör (ER) negatifliği (p=0.034), insan epidermal büyüme faktörü reseptör-2 pozitifliği (HER2) (p=0.030) ve nod negatifliği (p=0.023) arasında istatistiksel olarak anlamlı ilişki saptandı. Patolojik tam yanıt ile hastalığın evresi (II-III) (p=0.051) ve Ki-67 düzeyi (<%20/ ≥%20) (p=0.060) arasında sınırda istatistiksel anlamlılık mevcuttu.
Regresyon analizinde, diğer potansiyel prognostik faktörler ile birlikte değerlendirildiğinde, nod negatifliği ve ER negatifliği pCR’ı predikte eden bağımsız faktörler olarak saptandı (p=0.008, p=0.040, sırası ile). Patolojik tam yanıt elde edilen hasta grubuyla pCR sağlanamayan grup arasında hem hastalıksız sağkalım (DFS) hem de genel sağkalım (OS) açısından farklılık izlenmedi (p=0.315, p=0.576 sırası ile).
Sonuç: Çalışmamızda ER negatifliği ve nod negatifliği pCR’ı predikte eden bağımsız faktörler olarak saptandı. Ki-67’nin %20 üzerinde olması pCR açısından sınırda anlamlılık göstermekteydi. Luminal tip meme kanserli hasta grubunda patolojik tam yanıt prognostik bir faktör olarak saptanmadı.

Keywords

Luminal tip meme kanseri, neoadjuvan kemoterapi, patolojik tam yanıt

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