Endometrium kanserinde ekstrauterin tümör yayılımını tahmin etmek için kullanılan bir model

Year 2023, , 69 - 74, 28.06.2023

Birkan Karayünlü , Mehmet Ünsal , Fatih Kılıç , Taner Aksoy , Fatih Çelik , Çiğdem Kılıç , Abdurrahman Alp Tokalıoglu , Günsu Kimyon Cömert , Taner Turan

https://doi.org/10.52827/hititmedj.1126093

Abstract

Amaç: Endometrium kanseri tanısı ile evreleme cerrahisi uygulanan hastalarda ekstrauterin yayılımı öngören faktörler araştırıldı.
Amaç: Çalışmada ekstrauterin yayılımı tahmin etmek için demografik, cerrahi ve patolojik faktörler kullanılarak bir model oluşturmak amaçlandı.
Yöntemler: Çalışmaya endometrium kanseri tanısı alan ve evreleme cerrahisi uygulanan 355 hasta dahil edildi. Cerrahi prognostik faktörlerin ekstrauterin yayılım üzerindeki etkisi, tek değişkenli analiz ve çok değişkenli lojistik regresyon analizi kullanılarak analiz edildi.
Bulgular: 97 hastada ekstrauterin yayılım tespit edildi. Ekstrauterin yayılımı etkileyen faktörleri belirlemek için oluşturulan çok değişkenli bir lojistik regresyon modeli, lenfovasküler invazyon varlığını, servikal invazyonu, peritoneal sitoloji pozitifliğini ve tümör tipini bağımsız faktörler olarak belirledi. Bu dört bağımsız risk faktörü kullanılarak bir model oluşturulmuştur. Bu modele göre, risk faktörlerine sahip olmayan hastalarda ekstrauterin yayılım oranı %6,4, tüm risk faktörlerine sahip hastalarda %100 idi (p<0,05).
Sonuçlar: Endometrium kanseri tedavisinin planlanmasında ekstrauterin yayılımın tespiti esastır. Bu yayılımın klinik ve patolojik faktörler kullanılarak tanımlanması, yetersiz cerrahi uygulanan veya cerrahinin ciddi morbiditeye neden olacağı bir grup hastada uygun tedavinin belirlenmesine katkı sağlayacaktır.

Keywords

Endometrium kanseri, ekstrauterin yayılım, lenfatik/lenfatik olmayan metastaz

A model for predicting extrauterine tumor spread in patients with endometrial cancer

Abstract

A model for predicting extrauterine tumor spread in patients with endometrial cancer

Abstract
Background: The factors predicting extrauterine spread in patients undergoing staging surgery with the diagnosis of endometrial cancer were investigated.
Aims: The study aimed to create a model using demographic, surgical, and pathological factors to predict extrauterine spread.
Methods: Included in the study were 355 patients with a final diagnosis of endometrial cancer who underwent surgery for staging purposes. The effect of surgical-prognostic factors on extrauterine spread was analyzed using univariate analysis and multivariate logistic regression analysis.
Results: Extrauterine spread was detected in 97 patients. A multivariate logistic regression model that was created to determine the factors affecting extrauterine spread identified the presence of lymphovascular invasion, cervical invasion, peritoneal cytology positivity and tumor type as independent factors. A model was created using these four independent risk factors. According to this model, the rate of extrauterine spread was 6.4% in patients who did not have the risk factors and 100% in patients who had all the risk factors (p <0.05).
Conclusions: The detection of extrauterine spread is essential in planning a patient’s treatment. The definition of this spread by using clinical and pathological factors would contribute to determining the appropriate therapy in a group of patients who underwent insufficient surgery or in whom surgery would otherwise cause significant morbidity.

Keywords

Endometrial cancer, extrauterine spread, lymphatic/nonlymphatic metastasis, model

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