ENDOMETRİAL KANSER SAPTANAN OLGULARDA OPERASYON SONUÇLARININ VE BAZI PROGNOSTİK FAKTÖRLERİN DEĞERLENDİRİLMESİ

Öz

ÖZET
Amaç: Endometriyum kanseri dünyada kadınlar arasında dördüncü sırada görülmekte, jinekolojik kan-
serlerin ise yaklaşık yarısını oluşturmaktadır. Amacımız kliniğimizdeki endometriyum kanserli olguların
cerrahi tedavi sonuçları ve prognozlarını paylaşmaktır.
Gereç ve Yöntemler: 2010- 2013 yılları arasında endometrium kanseri tanısı alıp opere edilen 42
hastanın  dosyaları  retrospektif  olarak  incelenip,  hastaların  klinik  özellikleri,  operasyon  tipleri,  his-
topatolojik özellikleri ve prognostik faktörleri ile ilgili sonuçlar değerlendirilmiştir. Serviks kanserinden
ayrımı yapılamayan olgular veya tip 3 histerektomi yapılmak zorunda kalınan olgular çalışmaya dahil
edilmemiştir.
Bulgular: American Joint Committee on Cancer’in belirlediği sınıflama sistemine göre 29 hasta (% 69)
evre 1, 5 hasta evre 2 (% 12), 4 hasta evre 3 (% 9) ve 4 hasta (% 10) evre 4 olarak bulunmuştur. Evre 1’de
bulunan hastaların yaklaşık yarısında n=14 (% 48,2) tümör endometriumda sınırlı, myometrial invazyon
< ½ veya grade 1 olarak rapor edilmiş ve total abdominal histerektomi ve bilateral salpingo-ooforektomi
uygulanmıştır. Kalan hastalara TAH+BSO ilave olarak pelvik paraaortik lenf nodu diseksiyonu (PPLND),
omentektomi ve appendektomi ilave edilmiştir. PPLND uygulanan 28 hastada ortalama olarak 41,14
lenf nodu çıkarılmıştır. Hastalardan 14’ünde (% 33,3) lenfovasküler stromal invazyon (LVSI) bulunmuştur.
TAH+BSO yapılan olguların birinde yara yeri enfeksiyonu ve evisserasyon; lenf nodu diseksiyonu eklenen
hastaların üçünde yara yeri enfeksiyonu, birinde atelektazi, birinde üreter yaralanması ve bir tanesinde
pulmoner emboli gelişmiştir. Hastaların yaş dağılımı incelendiğinde erken evredeki hastaların yaşlarının
daha düşük olduğu buna karşın evre ilerledikçe yaş dağılımının arttığı bulunmuştur.
Sonuç: Endometrial kanserli olgular, diğer jinekolojik kanserlere göre daha erken bulgu vermesi sebe-
biyle erken evrelerde yakalanabilmektedir. Hastaların evresi ve genel durumuna göre tedavi şekilleri
değişmesine rağmen cerrahi standart bir tedavi olmuştur.
Anahtar kelimeler: Endometriyum kanseri; Prognoz; Cerrahi tedavi

ABSTRACT
Purpose: Endometrial cancer is the fourth leading cancer among women in the world and consists of
nearly half of all gynecological cancers. Our aim was to report surgical results and prognosis of endome-
trial cancer diagnosed in our clinic.
Methods: Fourty two endometrial cancer patients diagnosed and treated surgically between 2010 and
2013 were analyzed retrospectively. Clinical and surgical data of the patients, histopathological and
prognostic parameters related to outcomes were evaluated. The patients undergone type 3 hysterec-
tomy or the patients who couldn’t be differentially diagnosed from cervical cancer were excluded.
Results: According to the American Joint Committee on Cancer classification, 29 patients (69%) were
found to have in stage 1, 5 patients in stage 2 (12%), 4 patients in stage 3 (9%) and 4 patients (10%) in
stage 4 respectively. Approximately half of the patients (n = 14) (48.2%) in stage 1 had endometrially
limited tumor with myometrial invasion of <1/2, or grade 1 tumor and all were undergone TAH+BSO.
The rest of patients in stage 1 were additionally undergone pelvic para-aortic lymph node dissection
(PPLND), omentectomy and appendectomy. Mean number of removed lymph nodes 41.14. Stromal
lymphovascular invasion (LVS) were found in 14 patients (33.3%). Wound infection and evisceration was
developed in one patient. Three wound infection, one atelectasis, one ureter injury and one pulmonary
embolism were developed in patients with PPLND. Age of patients in the earlier stages was lower. The
age distribution of patients was found to increase with increase in the stage of the tumor.
Conclusion: Endometrial cancers can be diagnosed in earlier stages Due to early clinic symptoms com-
pared to other gynecological cancers. Although the treatment modalities can change in accordance with
stage of tumor and patients’ health status, surgery appears as the standard treatment modality.
Key words: Endometrial cancer; Prognosis; Operative therapy

Anahtar Kelimeler

• Endometriyum kanseri,Prognoz; Cerrahi tedavi

Öz

Purpose: Endometrial cancer is the fourth leading cancer among women in the world and consists of nearly half of all gyneco logical cancers. Our aim was to report surgical results and prognosis of endometrial cancer diagnosed in our clinic.Methods: Fourty two endometrial cancer patients diagnosed and treated surgically between 2010 and 2013 were analyzed retrospectively. Clinical and surgical data of the patients, histopathological and prognostic parameters related to outcomes were evaluated. The patients undergone type 3 hysterectomy or the patients who couldn’t be differentially diagnosed from cervical cancer were excluded.Results: According to the American Joint Committee on Cancer classification, 29 patients (69%) were found to have in stage 1, 5 patients in stage 2 (12%), 4 patients in stage 3 (9%) and 4 patients (10%) in stage 4 respectively. Approximately half of the patients (n = 14) (48.2%) in stage 1 had endometrially limited tumor with myometrial invasion of <1/2, or grade 1 tumor and all were undergone TAH+BSO. The rest of patients in stage 1 were additionally undergone pelvic para-aortic lymph node dissection (PPLND), omentec tomy and appendectomy. Mean number of removed lymph nodes 41.14. Stromal lymphovascular invasion (LVS) were found in 14 patients (33.3%). Wound infec tion and evisceration was developed in one patient. Three wound infection, one atelectasis, one ureter injury and one pulmonary embolism were developed in patients with PPLND. Age of patients in the earlier stages was lower. The age distribution of patients was found to increase with increase in the stage of the tumor.Conclusion: Endometrial cancers can be diagnosed in earlier stages Due to early clinic symptoms compared to other gynecological cancers. Al though the treatment modalities can change in accordance with stage of tumor and patients’ health status, surgery appears as the standard treatment modality

Anahtar Kelimeler

• Endometrial cancer,Prognosis; Operative therapy

Kaynakça

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