Kolorektal kanserde primer tümör lokalizasyonunun tüm evrelerdeki etkileri

Year 2019, , 433 - 443, 30.09.2019

Esin Oktay , Serkan Değirmencioğlu

https://doi.org/10.31362/patd.567575

Abstract

Amaç: Bu çalışmanın amacı erken ve ileri evre kolon kanseri
hastalarında tümör lokalizasyonunun etkilerini incelemektir.

Gereç ve Yöntem: 2013-2017 arasında Adnan Menderes
Üniversitesi'nin tıbbi onkoloji bölümüne başvuran  primer kolorektal kanser tanılı hastaları
retrospektif olarak taradık ve 249 hastayı çalışmaya dahil ettik.

Bulgular: Erken evrede, sol taraftaki kolorektal kanserler  erkeklerde anlamlı olarak daha yaygındı (p =
0.027). Sağ taraftaki tümörlerde nüks  kadın hastalarda daha erken gelişti (p =
0.043) ve kadın cinsiyet, genç yaş nüks süresi için bağımsız prognostik
faktörlerdi. PANRAS pozitif ve bilinmeyen mutasyon durumunun her iki taraftaki
tümörler için olumsuz prognostik faktörler olduğu bulundu.

Metastatik evrede, sol taraftaki tümörlerde PANRAS mutant olan
hastalar daha uzun süre yaşadılar (sırasıyla 49.0'a 25.5 ay, p <0.001). Birinci
basamak tedavide anti-EGFR ajanları alan sağ kolon kanseri hastalarında anti-VEGFR
ajanları alanlara göre ortalama yaşam süresi(OS) 11 ay, progresyona kadar geçen
süre(PFS) 1.8 ay daha uzundu. Sol kolon 
tümörlerinde, ilk basamak tedavide fark yoktu yalnızca PFS anti-VEGFR
ajanlarıyla daha uzundu (13 ay vs 6.3 ay ). PANRAS pozitif antiVEGFR tedavisi
alan hastalar içinde sol kolon yerleşimli tümörlerde OS ve PFS daha uzundu (OS
49.0 ay - 30.6 ay PFS, 13.2 ay ve 7.2 ay, p = 0.784).

Sonuç: Çalışmamızda primer tümör lokasyonuna göre verilen
tedavinin etkinlik sonuçları literatürle uyumlu değildi. Primer tümörün yeri,
kolon kanserinde moleküler alt tiplerin anlaşılması için bir geçiş dönemidir.
Sağ ve sol taraftaki tümörler arasında genomik farklılıkları araştıran
çalışmalar, gözlenen farkın biyolojik açıklamasının daha iyi anlaşılmasını
mümkün kılacaktır.

Keywords

kolorektal kanser, tümör lokalizasyonu, erken evre, metastatik evre

Supporting Institution

yok

The effects of primary tumour location on patients with all stages of colorectal cancer

Abstract

Abstract:

Purpose:The
aim of this study was to examine the effects of tumor localization in early and
advanced stage colon cancer patients.

Materials and Methods :This retrospective study enrolled  249 primary colorectal cancer (CRC) patients
at medical oncology department of Adnan Menderes University between 2013-2017.

Results:In
early stage, left sided tumors were significantly more common in
males(p=0.027). In right sided tumours recurrence developed earlier in female
patients(p=0.043) and female sex,young age were unfavorable prognostic factors
for the relapse time.  Positive and
unknown PANRAS mutation status were found to be unfavorable prognostic factors
for both side. In metastatic stage, patients with PANRAS mutant left sided
tumors lived longer than PANRAS negative patients(49.0 vs 25.5 months
respectively, p <0.001). OS was 11 months and PFS was 1.8 months longer with
anti-EGFR agents than anti-VEGFR agents, in right sided tumors.In left sided
tumors, there was no difference, only PFS was longer with anti-VEGFR agents(13
months vs 6.3 months). In PANRAS positive patients, OS and PFS were longer with
anti-VEGFR treatment in the left side tumors(OS 49.0 months vs 30.6 months PFS,
13.2 months vs 7.2 months, p=0.784).

Conclusions:
In our study, the efficacy results of the treatment which was given according
to the primary tumor location were not compatible with the literature. Primer
tumor location is a transition period for understanding of molecular subtypes
at the colon cancer. The on-going studies of genomic differences between right
and left sided tumors will able to better clarifying of the biologic explanation
of the observed difference.

Keywords

Colorectal cancer, tumour location, early stage, metastatic stage

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