Uterin seröz karsinomda seröz endometrial intraepitelyal karsinom varlığının prognostik değeri

Yıl 2024, Cilt: 49 Sayı: 2, 239 - 247, 30.06.2024

Günsu Kimyon Cömert , Burak Ersak , Abdurrahman Alp Tokalıoglu , Fatih Çelik , Duygu Tuğrul Ersak , Sevgi Ayhan , Fatih Kılıç , Osman Türkmen , Özlem Moraloğlu Tekin , Taner Turan

https://doi.org/10.17826/cumj.1392952

Öz

Amaç: Literatürde halen nadir bir antite olan seröz endometrial intraepitelyal karsinom (SEIC) ile birlikte olan veya olmayan uterin seröz karsinomun (USC) klinik-patolojik bulgularını, prognozunu ve sağkalım sonuçlarını araştırmak.
Gereç ve Yöntem: En az histerektomi yapılmış toplam 98 USC hastası incelendi. Dışlama kriterlerinden sonra, cerrahi evreleme yapılan toplam 76 USC'li hasta değerlendirildi. SEIC, invaziv yüksek dereceli endometriyal karsinoma benzeyen oldukça atipik hücreler tarafından stromanın invazyonu olmaksızın komşu atrofik endometriyumun yüzeyinin ve glandlarının değiştirilmesi olarak tanımlandı. Ameliyattan ölüme veya son ziyarete kadar geçen süre genel sağkalım (OS) olarak tanımlanmıştır.
Bulgular: Hastaların yarısında (n:38) SEIC varlığı gözlendi. SEIC'li USC'li hastalar daha yaşlıydı ve SEIC olmayanlara göre daha yüksek polipoid paterni vardı. 5 yıllık genel sağkalım (OS), SEIC olan ve olmayan hastalarda sırasıyla %44,8 ve %62,4 idi. SEIC'li veya SEIC'siz USC'li hastalarda diğer klinikopatolojik faktörler için istatistiksel anlamlılık yoktu İleri evre istatistiksel olarak 2,45 kat fazla ölüm riski ile ilişkiliydi. Ayrıca, evre, USC için OS'nin tek bağımsız faktörü olarak bulundu. SEIC'li USC'li hastalarda ise OS için tek bağımsız prognostik faktör olarak lenfovasküler alan tutulumu saptandı.
Sonuç: Polipoid patern varlığı SEIC dahil USC hastalarında anlamlı olarak daha yüksek olmasına rağmen, bağımsız olarak sağkalım ile ilişkili değildi. Evre, USC için OS ile ilişkili tek prognostik faktördü. Bununla birlikte, SEIC varlığının USC'nin sağkalımı üzerinde prognostik bir etkisi yoktu.

Anahtar Kelimeler

Seröz adenokarsinom, seröz intraepitelyal neoplazi, uterus, sağkalım

Prognostic value of the presence of serous endometrial intraepithelial carcinoma in uterine serous carcinoma

Öz

Purpose: To investigate the clinical-pathological findings, prognosis, and survival outcome of uterine serous carcinoma (USC) with or without serous endometrial intraepithelial carcinoma (SEIC) which is still a rare entity in literature.
Materials and Methods: A total of 98 patients with USC who underwent at least a hysterectomy were reviewed. After elimination for exclusion criteria, totally 76 patients with USC who had surgical staging were evaluated. SEIC was defined as the replacement of the surface and glands of the adjacent atrophic endometrium without invasion of the stroma by the highly atypical cells resembling invasive high-grade endometrial carcinoma. The period from surgery to death or last visit was defined as overall survival (OS).
Results: The presence of SEIC was observed in half (n:38). Patients who had USC with SEIC were older and had a higher polypoid pattern than those without SEIC. The 5-year overall survival (OS) was 44.8% and 62.4% in patients with and without SEIC, respectively. There was no statistical significance for other clinicopathological factors in patients who had USC with or without SEIC. The advanced stage was related to a statistically significant hazard ratio for death of 2.45. Furthermore, the stage was found as the only independent factor of OS for USC. And, lymphovascular space involvement was determined as the only independent prognostic factor for OS in patients that had USC with SEIC.
Conclusion: Although the presence of polypoid pattern was significantly higher in patients who had USC including SEIC, it was not associated with survival independently. The stage was the only prognostic factor related to OS for USC. However, the presence of the SEIC had no prognostic effect on the survival of USC.

Anahtar Kelimeler

Serous adenocarcinoma, serous intraepithelial neoplasia, uterus, survival

Kaynakça

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