REKÜRREN EPİTELYAL OVER KANSERİNİN CERRAHİ YÖNETİMİ

Year 2016, Volume: 19 Issue: 3, 99 - 106, 21.05.2018

Murat Öz , İlker Selçuk , Zeliha Fırat Cüylan Hüseyin Akıllı Ali Ayhan

Abstract

Epitelyal over kanseri’nin (EOK) standart yönetim şekli primer sitoredüktif cerrahi ve ardından verilen intravenöz platin tabanlı kemoterapidir.
İlk tedavi sonrası hastaların büyük bölümünde remisyon görülmesine rağmen ileri evre hastalıkta nihayetinde hastaların tamamına
yakını nüksetmektedir. Rekürren EOK’de henüz standartlaşmış bir yönetim şekli yoktur. Nüks hastaların değerlendirilmesi ve tedavi şekli
mutlaka bireyselleştirilmelidir. Nüks tanısı alan hastanın önünde iki seçenek vardır. Birincisi platin duyarlılığına göre belirlenecek kemoterapi
rejiminin alınması, ikincisi ise sekonder sitoredüksiyon (SSR) girişiminin ardından verilecek adjuvan kemoterapi. Henüz iki yöntem de
standart yönetime girmiş değildir, çünkü bu konuya açıklık getirecek kanıtlar henüz olgunlaşmamıştır. Bu derlemede son literatür ışığında
rekürren EOK hastalarında SSR girişiminin rasyoneli ve şimdiye dek yapılmış çalışmalar irdelenerek tedavinin bireyselleştirilmesi ve hasta
seçimi konusunda güncel yaklaşım oluşturulmaya çalışılacaktır. 

Keywords

Rekürren over kanseri, kemoterapi, sekonder sitoreduksiyon

SURGICAL MANAGEMENT OF RECURRENT EPITHELIAL OVARIAN CANCER

Abstract

Primary cytoreductive surgery followed by platinum based intravenous chemotherapy is the mainstay of the treatment in epithelial ovarian
cancer (EOC). Most of the patients Show complete remission after the initial therapy. However, patients with advanced stage disease
will eventually recur. There is not a standardized management for recurrent EOC. The management and therapeutic options should be
highly individualized for recurrent EOC patients. There are two majör options fort he patients with recurrent EOC: first option is intravenous
chemotherapy, which should be established according to the platinum sensitivity of the tumor. Second option is adjuvant intravenous
chemotherapy followed by secondary cytoreductive surgery (SCR). Due to lack of high quality evidence, there is not a standard
approach for recurrent EOC. In the review article, we evaluated the rationale in the management of recurrent EOC and tried to establish a
current approach for individualizing the management and patient selection for SCR in EOC.

Keywords

recurrent ovarian cancer, chemotherapy, secondary cytoreduction

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