Evre II-III Endometrium Kanserinde FIGO 1988 ve 2009 Evreleme Sisteminin Sağkalıma Etkisi Üzerinden Karşılaştırılması

Year 2017, Volume: 20 Issue: 3, 16 - 21, 04.08.2019

Ayşe Altınok , İsmet Şahinler

Abstract

Başlık 

Evre II-III Endometrium Kanserinde FIGO 1988 ve 2009 Evreleme Sisteminin Sağkalıma Etkisi Üzerinden Karşılaştırılması

Türkçe Özet 

  Amaç: Endometrium kanseri
dünyada en sık görülen jinekolojik malignansidir. Çoğunlukla erken evrede tanı
konulur. Olguların % 5 ila 20'si Evre II veya III'de tespit edilir. Bu
hastaların prognozu hakkında daha detaylı bilgi edinilmesini sağlamak üzere
FIGO, 2009’da yeni bir evreleme sistemi oluşturmuştur. Kliniğimizde, FIGO
1988’e göre evrelendirilmiş ve tedavi edilmiş hastaların sağkalımlarının, bu
evreleme farklılığından nasıl etkilendiği bu çalışma ile araştırılmıştır.

Gereç ve Yöntemler: Evre II ve III
endometrium kanseri tanısı konmuş 167 hasta, FIGO 2009 evreleme sistemine göre
yeniden evrelendirildi. Prognostik faktörler ile hastalıksız ve genel sağkalım
analizleri FIGO’nun her iki evreleme sistemine göre yapılarak karşılaştırma
yapıldı.

Bulgular: Her iki evreleme
sisteminde (FIGO 1988 ve FIGO 2009) de olguların %42’si (n=70) Evre II; %26’sı
(n=43) evre IIIA; %5’i (n=9) evre IIIB’ydi. Figo 1988’in Evre IIIA şeklinde belirlenen
17 olgu (%10), 2009 evrelemesinde Evre II olarak tanımlandı. Yine FIGO 1988’de
Evre IIIC olarak tanımlanan 28 olgunun 19’u (%11) Evre IIIC1; 9’u (%5) Evre
IIIC2 olarak yeniden evrelendirildi. Sağkalım analizinde FIGO 1988 ve FIGO 2009
arasında Evre II, IIIA ve IIIB arasında istatistiksel bir fark bulunmadı. Evre
IIIC1 ve C2 arasındaki 5 yıllık sağ kalım farkı ise anlamlıydı (sırasıyla %74,
%67; p=0,002). Hastalıksız sağkalımda da aynı şekilde Evre II, IIIA ve IIIB
arasında bir farklılık saptanmazken, Evre III C1 ve IIIC2 arasında anlamlı
farklılık saptandı ( sırasıyla %74, %56; p= 0,002).

Sonuç: Çalışmamızda;
endometriyum kanserinde kullanılan FIGO 2009 evreleme sisteminin, Evre IIIC1 ve
IIIC2 grubundaki hastaların prognozu hakkında daha detaylı bilgi verdiği
bulunmuştur.

İngilizce Özet (Abstract):

Objective: Endometrial cancer is the most
common gynecological malignancy in the world. It is usually diagnosed at an
early stage. 5 to 20% of cases are diagnosed in Stage II or III. To provide
more detailed information about the prognosis of these patients, FIGO has
created a new staging system in 2009. This study investigates how the survival
of patients staged and treated according to FIGO 1988 in our clinic is affected
by the new system.

Material
Method: 167 Patients with stage II and
III endometrial cancer diagnosed were re-staged according to the FIGO 2009
staging system. Prognostic factors and disease-free and overall survival
analysis were compared according to old and new staging systems.

Results: In both the staging systems (FIGO 1988 and FIGO
2009), 42% of cases (n = 70) were stage II, 26% (n = 43) were stage IIIA; 5%
(n=9) were stage IIIB. Seventeen cases (10%) defined by FIGO 1988
as Stage IIIA were evaluated as Stage II in the 2009 staging. Nineteen of the
28 patients (11%), defined as stage IIIC in FIGO 1988, were stage IIIC1; 9 (5%)
were re-staged as Stage IIIC2. Survival analysis showed no statistically
significant difference between FIGO 1988 and FIGO 2009 between Stage II, IIIA
and IIIB. The 5-year survival difference between stage IIIC1 and C2 was
significant (74%, 67%, p = 0.002, respectively).

Conclusion: In our study; the FIGO 2009 staging system used in
endometrial cancer has been found to provide more detailed information about
the prognosis of patients in stage IIIC1 and IIIC2 groups.

Giriş

Gereç ve Yöntem

Bulgular

Tartışma

Kaynakça

Keywords

Endometrium kanseri, Evreleme, Radyoterapi

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