Metastatik kolon kanserinde prognostik faktörlerin analizi

Year 2026, Issue: 1, - , 04.02.2026

Seray Saray , Yakup İriağaç

https://doi.org/10.18663/tjcl.1803902

https://izlik.org/JA39GN68CB

Abstract

Amaç: Kolorektal kanser (CRC), kansere bağlı ölümlerin ikinci önde gelen nedeni ve dünya genelinde en sık görülen üçüncü kanser türüdür. Bununla birlikte, tümör biyolojisinin karmaşıklığı nedeniyle, güvenilir prognostik faktörlerin belirlenmesi hayati önem taşımaktadır.
Gereç ve Yöntemler Balikesir Ataturk Şehir Hastanesi'nde takip edilen metastatik kolon kanseri olan 71 hastanın retrospektif analizi gerçekleştirildi. Trombosit-lenfosit oranı (PLR), nötrofil-lenfosit oranı (NLR) ve sistemik immün-enflamasyon indeksi (SII) hesaplandı. Sağkalım analizi Kaplan-Meier yöntemi kullanılarak yapıldı ve prognostik faktörler Cox regresyon analizi ile değerlendirildi.
Sonuçlar: Ortalama genel sağkalım (OS) 34,8 ay idi. Vücut kitle indeksi (BMI) <20 kg/m² olan hastalarda sağkalım anlamlı derecede daha kısaydı (21 ay; p = 0,001). Doğu Kooperatif Onkoloji Grubu Performans Durumu (ECOG PS) ≥2, de novo metastaz varlığı ve periton metastazları, daha kötü sağkalımla ilişkiliydi. Tek değişkenli analizde, yüksek PLR (HR: 1,81) ve yüksek SII (HR: 2,16) anlamlı olarak artmış mortalite ile ilişkiliydi. Tümör belirteçleri arasında, yüksek karbonhidrat antijeni 19-9 (CA 19-9) (HR: 1,86) ve daha belirgin olarak yüksek karsinoembriyonik antijen (CEA) (HR: 3,83) sağkalımı olumsuz etkiledi. Çok değişkenli analiz, ECOG PS ≥2, periton metastazı, yüksek SII ve yüksek CEA’yı bağımsız prognostik faktörler olarak tanımladı. Yaş, cinsiyet, tümör yeri, mutasyon durumu ve karaciğer metastazı istatistiksel olarak anlamlı prognostik faktörler değildi.
Sonuç: Klinik faktörler (ECOG PS, BMI), metastaz özellikleri (peritoneal, de novo), inflamatuar belirteçler (PLR, SII) ve tümör belirteçleri (CA 19-9, CEA), metastatik kolon kanserinde sağkalımın önemli belirleyicileridir. Özellikle CEA, güçlü bir bağımsız prognostik faktör olarak ortaya çıkmıştır.

Keywords

kolorektal kanser , metastatik , prognostik faktörler , trombosit-lenfosit oranı (PLR) , sistemik immün-enflamasyon indeks (SII)

Ethical Statement

Etik Onay: Bu çalışma, Balıkesir Atatürk Şehir Hastanesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Onay No: E-30041352-514.19.99-281272412 2025/06/62 Tarih: 19.06.2025). Hasta Onayı: Çalışma retrospektif arşiv taraması olduğundan, hastalardan bilgilendirilmiş onam alınmamıştır. Veri Kullanılabilirliği: Mevcut çalışma sırasında kullanılan ve/veya analiz edilen veri setleri, makul bir talep üzerine ilgili yazardan temin edilebilir. Yazar Katkıları: Cerrahi ve Tıbbi Uygulamalar S.S.,Y.İ. Konsept S.S.,Y.İ. Tasarım S.S.,Y.İ. Veri Toplanması veya İşlenmesi S.S.,Y.İ. Analiz veya Yorum S.S.,Y.İ. Literatür Taraması S.S. Yazım S.S. Tüm yazarlar makaleyi incelemiştir. Çıkar Çatışması: Yazarlar herhangi bir çıkar çatışması olmadığını beyan etmektedir. Finansman: Yazarlar bu çalışma için herhangi bir fon almamıştır. Bu çalışma, 2. AVOD (Avrasya Disiplinlerarası Onkoloji Derneği) kongresinde poster olarak sunulmuştur. Bu çalışma retrospektif bir arşiv taraması olduğundan, hastalardan bilgilendirilmiş onam alınmamıştır. Çalışma, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.

Analysis of prognostic factors in metastatic colon cancer

https://izlik.org/JA39GN68CB

Abstract

Aim: Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths and the third most common cancer globally. However, due to the complexity of tumor biology, identifying reliable prognostic factors remains crucial.
Material and Methods: We conducted a retrospective analysis of 71 patients with metastatic colon cancer who were followed at Balikesir Ataturk City Hospital. The platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were calculated. Survival analysis was performed using the Kaplan-Meier method and prognostic factors were evaluated with Cox regression analysis.
Results: The median overall survival (OS) was 34.8 months. Survival was significantly shorter in patients with a BMI <20 kg/m² (21 months; p = 0.001). An Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥2, the presence of de novo metastases, and peritoneal metastases were all associated with poorer survival. In univariate analysis, elevated PLR (HR: 1.81) and elevated SII (HR: 2.16) were significantly associated with increased mortality. Among tumor markers, elevated carbohydrate antigen 19-9 (CA 19-9) (HR: 1.86) and, more prominently, elevated carcinoembryonic antigen (CEA) (HR: 3.83) negatively impacted survival. In the multivariate Cox regression analysis, ECOG performance status ≥2, the presence of peritoneal metastasis, elevated systemic immune-inflammation index (SII), and elevated carcinoembryonic antigen (CEA) were identified as independent prognostic factors for overall survival.
Conclusion: Clinical factors (ECOG PS, BMI), metastasis characteristics (peritoneal, de novo), inflammatory markers (PLR, SII), and tumor markers (CA 19-9, CEA) are significant predictors of survival in metastatic colon cancer. CEA, in particular, emerged as a strong independent prognostic factor.

Keywords

colorectal cancer , metastatic , prognostic factors , platelet-to-lymphocyte ratio (PLR) , systemic immune-inflammation index (SII)

Ethical Statement

Ethical Approval: This study was approved by the Balikesir Ataturk City Hospital’s Non-Invasive Clinical Research Ethics Committee (Approval No: E-30041352-514.19.99-281272412 2025/06/62 Date: 19.06.2025). Patient Consent: Since the study was a retrospective archive search, informed consent was not obtained from the patients. Data Availability: The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. Author Contributions: Surgical and Medical Practices S.S.,Y.İ. Concept S.S.,Y.İ. Design S.S.,Y.İ. Data Collection or Processing S.S.,Y.İ. Analysis or Interpretation S.S.,Y.İ. Literature Search S.S. Writing S.S. All the authors reviewed the manuscript. Competing Interests: The authors declare no competing interests. Funding: The authors received no funding for this study. This study was presented as a poster at the 2nd AVOD (Eurasian Interdisciplinary Oncology Association) congress. Since this study was a retrospective archive search, informed consent was not obtained from the patients. The study was conducted in accordance with the principles of the Declaration of Helsinki.

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