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Öz

Objectives: Comparison of clinicopathological and demographic features of early and late stage gastric cancer patients and determination of prognostic factors that specific for late stage patients.Patients and methods: Files of 145 patients diagnosed with adenocarcinoma, operated at Zonguldak Karaelmas University School of Medicine Training and Research Hospital were examined retrospectively.Results: There were 19 early-stage patient. Lymph node involvement of two patients was positive. Three patients had been died non-cancer related causes. Average follow-up time was 58.7 months for 16 patient. Average survey of late stage patients were 26.10 months. The factors that affect survey statistically significant were determined as age, T-N score and number of lymph node that removed. Prognostic factors that specific to the stages were examined: age and lymph node number that removed for stage 2, age, macroscopic image, taking chemotherapy, size and differentiation degree for stage 3, size for stage 4 was determined as a factors that effect to survey.Conclusion: In our study, depth of invasion was associated with lymph node positivity in early stage. The detection of number of lymph node resection as a prognostic factor in late stage might be due to insufficient lymph node dissection to 46 of 126 patients. Lack of statistical difference in terms of survey between stages 3-4 may be due to incorrect staging because of lower lymph node removal in stage 3 than stage 4 and extension of survey because of removal of more lymph nodes in stage 4

Anahtar Kelimeler

• Clinicopathological; demographic differences; gastric cancer; prognostic factors

Erken ve ileri evre mide kanserli hastaların klinikopatolojik ve demografik özelliklerinin karşılaştırılması

Öz

Amaç: Erken ve geç evre mide kanserli hastaların klinikopatolojik, demografik özelliklerini karşılaştırmak ve ileri evre hastalarda evreye özel prognostoik faktörleri belirlemek. Hastalar ve yöntemler: Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Uygulama ve Araştırma Hastanesinde mide adenokarsinomu tanısı konulmuş ve ameliyat edilmiş 145 hastanın dosyaları retrospektif olarak incelendi. Bulgular: Çalışmamızda 19 erken evre hasta vardı. İki hastada lenf nodu tutulumu pozitifti. Üç hasta kanser dışı nedenlerden dolayı kaybedildi. Diğer 16 hastada ortalama takip süresi 58.7 aydı. İleri evre mide kanserli hastaların ortalama sağkalımı 26.10 aydı. Regresyon analizinde sağkalıma istatistiksel olarak anlamlı düzeyde etki eden faktörler; yaş, T-N skoru ve çıkarılan lenf nodu sayısı idi. Evrelere özel prognostik faktörler incelendiğinde ise evre 2’de yaş, çıkarılan lenf nodu sayısı, evre 3’de yaş, makroskopik görünüm, kemoradyoterapi almak, boyut ve diferansiyasyon derecesi, evre 4’de tümör boyutu sağkalıma etki eden faktörlerdi. Sonuç: Çalışmamızda erken evrede lenf nodu pozitifliği ile invazyon derinliği ilişkiliydi. İleri evrede çıkarılan lenf nodu sayısının prognostik faktör olarak saptanmasının nedeni 126 hastanın 46’sına yetersiz lenf nodu diseksiyonu yapılması olabilir. Evre 3-4 arasında sağkalım açısından istatistiksel fark olmaması evre 3’de çıkarılan lenf nodu ortalamasının evre 4’e göre düşük kalmasından dolayı yanlış evrelemeden, evre 4’de daha fazla lenf nodu çıkarılmasının sağkalımı uzatmasından kaynaklanabilir.

Anahtar Kelimeler

• Klinikopatolojik, demografik farklılıklar, mide kanseri, prognostik faktörler

Kaynakça

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