Adjuvant Kemoterapi Almış FIGO 2014 Evre II Yüksek-Grade Seröz Over Kanseri Olan 49 Hastanın Klinikopatolojik Özellikleri

Year 2022, , 64 - 69, 30.06.2022

Okan Oktar , Hande Esra Koca , Candost Hanedan , Caner Kose , Fulya Kayıkçıoğlu , Caner Çakır

https://doi.org/10.46969/EZH.1096256

Abstract

Amaç: Evre 2 yüksek-grade seröz over kanseri tanısı alan ve cerrahi sonrasında adjuvant kemoterapi alan hastaların klinikopatolojik özellikleri ve nüks paternlerinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Kliniğimizde 1993-2021 yılları arasında tedavi görmüş, yüksek-grade seröz over kanseri nedeniyle total abdominal histerektomi + bilateral salpingooferektomi + pelvik-paraaortik lenf nodu diseksiyonu +/- omentektomi yapılan, adjuvan kemoterapi alan, FIGO 2014 evreleme sistemine göre evre 2 olan, 49 hasta çalışmaya dahil edilmiştir.
Bulgular: Hastaların evre dağılımı değerlendirildiğinde, evre IIA olan 27 hasta (%55,1), IIB olan 22 hasta (%44,9) idi. 49 hastanın 16’sında (%28,6) rekürrens gelişti. Rekürrens gelişen hastalarda nüks gelişen bölgelere bakıldığında sadece pelvik 3 (%6,1), sadece abdomen 12 (%24,5) iken abdominal + pelvik nüks 1 (%2) hastada gelişti. Nüks gelişen 7 hastaya kemoterapi verilirken, 1 hastaya sekonder sitoredüksiyon uygulandı. 8 hastaya ise sekonder sitoredüksiyona ek olarak kemoterapi verildi.
Sonuç: Kliniğimizde 1170 hasta seröz over kanseri nedeniyle opere edilmiş olup bunların sadece 49 (% 4,18) tanesi yüksek gradeli, FIGO 2014 evreleme sistemine göre evre 2 kanserdir. Çalışmamıza dahil olan hastalarda nüks oranı %28,6’ dır. Nüks gelişen 7 hasta evre 2A (%43,75), 9 hasta evre 2B (%56,25) idi. Hastalığın nüksü %75 oranında batında görülmüştür. Evre 2 hastalarda nüks oranı azımsanamayacak derecede yüksektir. Bu nüksler sağkalımı yakından ilgilendirmektedir.

Keywords

Seröz overyan kanser, kemoterapi, rekürrens

Thanks

Teşekkür ederiz.

Clinicopathological Characteristics of 49 Patients with FIGO 2014 Stage II High-Grade Serous Ovarian Cancer Who Received Adjuvant Chemotherapy

Abstract

Objective: We aimed to investigate the clinicopathological features and recurrence patterns of patients who were diagnosed with stage 2 high-grade serous ovarian cancer and received adjuvant chemotherapy after surgery.
Material and Methods: 49 patients treated in our clinic between 1993-2021, who underwent total abdominal hysterectomy + bilateral salpingo-oophorectomy + pelvic-paraaortic lymph node dissection +/- omentectomy for high-grade serous ovarian cancer, received adjuvant chemotherapy, who were stage 2 according to the FIGO 2014 staging system was included in the study.
Results: When the stage distribution of the patients was evaluated, stage IIA was detected 27 patients (55.1%), and IIB was detected 22 patients (44.9%). Recurrence developed in 16 (28.6%) of 49 patients (27 patients had stage IIA, 22 patients had IIB) Considering the recurrence areas of the patients with recurrence, only pelvic 3 (6,1%), only the abdomen 12 (24,5%), while abdominal + pelvic recurrence developed in 1 (2%) patient. While chemotherapy was given to 7 patients who developed relapse, secondary cytoreduction was applied to 1 patient. Chemotherapy was given to 8 patients in addition to secondary cytoreduction.
Conclusion: In our clinic, 1170 patients were operated for serous ovarian cancer, and only 49 (4.18%) of them were high grade, stage 2 cancer according to the FIGO 2014 staging system. The recurrence rate in the patients included in our study was 28.6%. 7 patients who developed relapse were stage 2A (43.75%), and 9 patients were stage 2B (56.25%). The recurrence of the disease was seen in the abdomen at a rate of 75%. The recurrence rate in stage 2 patients is considerably high. These recurrences are closely related to survival.

Keywords

Serous ovarian cancer, chemotherapy, recurrence

References

• 1. Prat J; FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014 Jan;124(1):1-5.
• 2. Heintz APM, Odicino F, Maisonneuve P, et al: Carcinoma of the ovary. In FIGO annual report on the results of treatment in gynecological cancer. Int J Obstet Gynecol 2006;95:S161
• 3. Torre LA, Trabert B, DeSantis CE ve ark. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018 Jul;68(4):284-296.
• 4. Trimbos JB, Schueler JA. Watch and wait after careful surgical treatment and staging in well-differentiated early ovarian cancer 1991;67:597-602
• 5. Ye S, Yang J, You Y ve ark. Comparison of Clinical Characteristic and Prognosis between Ovarian Clear Cell Carcinoma and Serous Carcinoma: A 10-Year Cohort Study of Chinese Patients. PLoS One 2015;10(7):e0133498.
• 6. Organization WH. WHO handbook for reporting results of cancer treatment: World Health Organization; 1979.
• 7. Robboy, S.J., Robboy's pathology of the female reproductive tract. 2009: Elsevier Health Sciences.
• 8. S. Lheureux, C. Gourley, I. Vergote ve ark. Epithelial ovarian cancer, Lancet 2019; 393: 1240–53
• 9. Bahadır Saatli , Turab Janbakhisov , Özlen Emekçi ve ark. Peritoneal karsinomatoza bulgusu olmayan çok yüksek serum CA 125 değeri olan adneksiyal kitlelerin klinikopatolojik değerlendirilmesi, Dokuz Eylül Tıp Fakültesi Dergisi 2013;27(1):33-38
• 10. Yetimalar H, Köksal A, Uğur H, ve ark. Transvaginal ultrasonografi ile adneks kitlelerinin benignmalign ayrımının yapılması [Malign or benign differantial diagnosis of adnexial masses with transvaginal ultrasonography]. T Klin Obstet 2001;11:174-179.
• 11. Tropé C, Kaern J. Adjuvant chemotherapy for early-stage ovarian cancer: review of the literature. J Clin Oncol. 2007(25):2909–20.
• 12. J.K. Chan, C. Tian, B.J. Monk ve ark., Prognostic factors for high-risk earlystage epithelial ovarian cancer: a Gynecologic Oncology Group study, Cancer 112 (10) (2008) 2202–2210.
• 13. Amate P, Huchon C, Dessapt AL ve ark. Ovarian cancer: sites of recurrence. Int J Gynecol Cancer. 2013 Nov;23(9):1590-6.