Research Article
Cerrahi uyguladiğimiz endometrial kanserli hastalarimizin prognozlarini etkileyen klinik ve patolojik faktörler
Abstract
Amaç: Endometrium kanseri (EK) için çeşitli prognostik faktörler tanımlanmıştır. Biz de kliniğimizde EK tanısı alarak opere ettiğimiz hastalarımızın klinik ve patolojik faktörlerini prognoz yönünden araştırmayı amaçladık.
Materyal ve Metod: Kadın Hastalıkları Kliniğimizde 2016-2019 yılları arasında EK sebebi ile cerrahi uygulanan 54 hasta çalışmaya dahil edildi. Hastaların yaşları, gravidaları, vücut kitle indeksleri, Ca 125 değerleri, endometrial kalınlıkları, histopatolojik ön tanıları, perioperatif hemogram değerleri, histopatolojik örneklemeleri, gradeleri, myometrial invazyonları, tümör çapları, servikal tutulumları, lenf nodu örneklemelerinin tüm sonuçları not edildi. FIGO evreleri ile tümör parametrelerinin ilişkisi ve perioperatif hemogram değerleri ilişkisi değerlendirildi. İstatistiksel analiz için ortalama, minimum-maksimum, yüzde değerleri kullanıldı. Değişkenler arasındaki ilişki değerlendirmesi için Spearman’ın korelasyon analizi kullanıldı.
Bulgular: Hastaların tümüne histerektomi + bilateral salpingo-oforektomi ve pelvik/paraaortik lenf nodu diseksiyonu uygulanmış olduğu görüldü. Hastaların % 51.9’u Evre 1, % 22.2’si Evre 2, % 16.7’si Evre 3 ve % 9.3’ünün Evre 4’tü. Lenf nodu diseksiyonu yapılan hastalardan 3’ünde pelvik, 8’inde pelvik ve paraaortik lenf nodu metastazı gösterildi. Endometrioid adenokanserlerde histolojik grade genellikle 1-2 iken diğer tümörlerde grade 2-3’tü. Lenfovasküler saha invazyonu (LVSI) pozitifliği 26 hastada (%48.1) tespit edildi. Bunların 12’si grade 2, 14’ü ise grade 3 tümörü olan hastalardı. Servikal yayılımı olan 26 hastanın 24’ünde LVSI pozitifliği mevcuttu. Servikse yayılım olan hastaların 12’si endometrioid, 10’u seröz, 2’si ise müsinöz karsinom olarak raporlanmıştı.
Sonuç: Tümörün histolojik tipi, grade’i, myometrial invazyon derecesi, boyutu, LVSI pozitifliği, servikal yayılımı ve lenf nodu tutulumu EK’nın prognostik değişkenleridir.
Keywords
Supporting Institution
Amasya Üniversitesi Etik Kurulu
Project Number
15386878-044
References
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Year 2018,
Volume: 21 Issue: 2, 17 - 23, 15.03.2020
Abstract
Project Number
15386878-044
References
- 1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:359–386. 2. Toptaş T, Şimşek T, Karaveli Ş. Prognostic risk factors for lymph node involvement in patients with endometrial cancer. Turk J Obstet Gynecol 2017;14:52-57. 3. Selçuk İ, Küçükyıldız İA, Güngör T, Ayhan A. Obesity and gynecologic cancers. Türk Jinekolojik Onkoloji Dergisi 2016;2:1-14. 4. Dijkhuizen FP, Mol BW, Brölmann HA, Heintz AP. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer 2000;89:1765–1772. 5. Touboul C, Piel B, Koskas M, et al. Factors predictive of endometrial carcinoma in patients with atypical endometrial hyperplasia on preoperative histology. Anticancer Res 2014;34:5671–5676. 6. Solmaz U, Ekin A, Mat E, et al. Current management for endometrıal cancer. Türk jinekolojik onkoloji dergisi 2016:1;7-16. 7. Creasman WT, Odicino F, Maisonneuve P, et al. Carcinoma of the corpus uteri. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet 2006;95:105–143. 8. Creutzberg CL, van Putten WL, Koper PC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma Lancet 2000;355:1404–1411. 9. Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS. Prognostic factors associated with recurrence in clinical stage 1 adenocarcinoma of the endometrium. Obstet Gynecol 1991;78:63-69. 10. MacMahon B. Risk factors for endometrial cancer. Gynecol Oncol 1974;2:122-129. 11. Smith M, McCartney AJ. Occult, high-risk endometrial carcinoma. Gynecol Onco11985;22:154-161. 12. Fortier KJ. Postmenopausal bleeding and the endometrium. Clin Obstet Gynecol 1986;29:44-45. 13. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009;105:103-104. 14. Melhem MF, Tobon H. Mucinous adenocarcinoma of the endometrium: a c1inicopathalogic review of 18 cases. Int J Gynaecol Patho1 1987;6:347-355. 15. Goff BA, Kato D, Schmidt RA, et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecol Onco11994;54264-268. 16. Abeler VM, Kjorstad KE. Clear cell carcinoma of the endometrium: a histopathological and clinical study of 97 cases. Gynecol Oncol 1991;1:207-217. 17. Kadar N, Malfetano JH, Homesley HD. Determinants of survival of surgically staged patients with endometrial carcinoma histologically confined to the uterus: Implications for therapy. Obstet Gynecol 1992;80:655-659. 18. Kumar S, Podratz KC, Bakkum-Gamez JN, et al. Prospective assessment of the prevalence of pelvic, paraaortic and high paraaortic lymph node metastasis in endometrial cancer. Gynecol Oncol 2014;132:38-43. 19. Aydın HA, Erdoğan G, Pestereli HE, Şimşek T. Role of less commonly agreed risk factors on disease recurrence in endometrial cancer: a propensity score matched comparison. Turk J Obstet Gynecol 2019;16:55-62. 20. Morrow CP, Bundy BN. Relationship between surgical- pathological risk factors and outcome in clinical stage I and II carcinoma of endometrium:a Gynecologic Oncology Group study. Gynecol Oncol 1991:40:55-65. 21. Kaku T, Tsuruchi N, Tsukamoto N, Hirakawa T, Kamura T, Nakano H. Reassessment of myometrial invasion in endometrial carcinoma. Obstet Gyneco 1994;84:979-982. 22. Jantarasaengaram S, Praditphol N, Tansathit T, Vipupinyo C, Vairojanavong K. Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer. Ultrasound Obstet Gynecol 2014;43:569–574. 23. Kitchener H, Swart AM, Qian Q, et al. Efficacy of systemic pelvic lymphadenectomy in early stage endometrial cancer (MRC ASTEC trial): a randomized controlled trial. Lancet 2009;373:125–136 24. Mariani A, Webb MJ, Rao SK, Lesnick TG, Podratz KC. Significance of pathologic patterns of pelvic lymph node metastases in endometrial cancer. Gynecol Oncol 2001;80:113–120. 25. Soliman PT, Frumovitz M, Spannuth W, et al. Lymphadenectomy during endometrial cancer staging: practice patterns among gynecologic oncologists. Gynecol Oncol 2010;119:291–294. 26. Benedetti Panici P, Basile S, Maneschi F, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst 2008;100:1707–1716. 27. Elinav E, Nowarski R, Thaiss CA, Hu B, Jin C, Flavell RA. Inflammationinduced cancer: crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer 2013;13:759-771. 28. Yıldız Ç, Akkar ÖB, Karakuş S, et al. The diagnostic value of preoperative neutrophil to lymphocyte ratio in patients with endometrial, cervical and ovarian cancers. Türk Jinekolojik Onkoloji Dergisi 2015;3:79-84.
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Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Article |
| Authors | |
| Project Number | 15386878-044 |
| Publication Date | March 15, 2020 |
| Submission Date | January 28, 2020 |
| Published in Issue | Year 2018 Volume: 21 Issue: 2 |