Evre IIIC Endometrium Kanserinde Paraaortik Lenf Nodu Metastazı Varlığına Göre Klinik, Cerrahi ve Patolojik Faktörlerin Dağılımı

Year 2023, , 1748 - 1752, 03.07.2023

Okan Aytekin , Yeşim Özkaya Uçar , Burak Ersak , Fatih Çelik , Günsu Kimyon Cömert , Bülent Özdal

https://doi.org/10.38136/jgon.1186328

Abstract

Özet
Amaç: Bu çalışmada Evre IIIC1 ve evre IIIC2 endometrium kanserinde, hasta grupları arasında klinik, cerrahi ve patolojik risk faktörlerinin dağılımını incelemek ve farklılığı tanımlamak amaçlanmıştır.
Gereçler ve Yöntem: Kliniğimizde FIGO 2009 kriterlerine göre evre IIIC1-2 endometrium kanseri tanısı alan 115 hasta çalışmaya dâhil edildi. Hastaların demografik, klinik, cerrahi ve patolojik özellikleri hasta dosyalarından ve patoloji raporlarından retrospektif olarak elde edildi.
Bulgular: Hastaların 39’unda (%33.9) sadece pelvik lenf nodu metastazı, 14’ünde (%12.2) sadece paraaortik lenf nodu metastazı, 62’sinde (%53.9) ise hem pelvik hem paraaortik lenf nodu metastazı mevcuttu. Otuz dokuz (%33.9) hasta FIGO IIIC1, 76 (%66.1) hasta FIGO IIIC2 evredeydi. Evre IIIC2 hasta grubunda evre IIIC1’e göre derin myometrial invazyon ve malign peritoneal sitoloji istatistiksel olarak anlamlı yüksekti. Buna karşın yaş, tümör boyutu, çıkarılan lenf nodu sayısı, preoperatif CA 125 değeri, FIGO grade derecesi, lenfovasküler alan invazyonu, servikal tutulum durumu ve adneksal metastaz durumu ile hastalığın paraaortik bölgeye yayılıp yayılmaması arasında anlamlı farklılık gözlenmedi.
Sonuç: Evre IIIC endometrium kanserinde paraaortik lenf nodu metastazı varlığında derin miyometrial invazyon ve malign peritoneal sitoloji görülme olasılığı artmaktadır.

Keywords

Endometrium kanseri, evre IIIC, paraaortik lenf nodu metastazı

Distribution of Clinical, Surgical, and Pathological Factors in Stage IIIC Endometrial Cancer Patients with Paraaortic Lymph Node Metastasis

Abstract

Abstract
Aim: To analyze the distribution of clinical, surgical, and pathological risk variables among patient groups in stage IIIC1 and stage IIIC2 endometrium cancer, and to identify the differences.
Materials and Method: The study comprised 115 endometrial cancer patients identified as stage IIIC1-2 in our clinic, according to FIGO 2009 criteria. Patients' demographic, clinical, surgical, and pathological features were retrospectively extracted from patient files and pathology reports.
Results: Thirty-nine (33.9%) patients had only pelvic lymph node metastases, 14 (12.2%) patients had only paraaortic lymph node metastases, and 62 (53.9%) patients had both pelvic and paraaortic lymph node metastases. The stages of 39 (33.9%) patients were FIGO IIIC1 and 76 (66.1%) were FIGO IIIC2. Deep myometrial invasion and malignant peritoneal cytology were statistically higher in stage IIIC2 patients than in stage IIIC1 patients. However, age, tumor size, number of lymph nodes excised, preoperative CA 125 value, FIGO grade, lymphovascular space invasion, cervical involvement, and adnexal metastases did not found to be associated with the disease dissemination to the paraaortic area.
Conclusion: Deep myometrial invasion and malignant peritoneal cytology is higher in stage IIIC endometrial cancer patients with paraaortic lymph node metastases.

Keywords

Endometrial cancer, stage IIIC, paraaortic lymph node metastasis

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