MULTİPL PRİMER JİNEKOLOJİK TÜMÖRLER

Öz

Amaç: Kliniğimizde tedavi görmüş ve takibi devam eden multipl jinekolojik tümörlü hastalar görülme sıklığı, klinik ve patolojik özellikleri ve sağkalım açısından değerlendirilmiştir.

Gereç ve yöntem: 1992 ile 2010 yılları arasında jinekolojik malignite tanısıyla kliniğimize başvuran 2373 hasta retrospektif olarak incelenmiştir. Multipl jinekolojik organ kaynaklı neoplazi 26 (%1.09) hastada gözlenmiştir. 25 hastada iki primer neoplazi saptanırken, 1 hastada 3 primer neoplazi saptanmıştır. Yirmi üç hastada senkron kanser, 3 hastada ise sırası ile 7, 22 ve 24 yıl sonra metakron kanser gelişmiştir. Evrelemede FIGO 2009 sistemi kullanılmıştır. Endometrium-over kanserli hasta grubu için genel sağkalım Kaplan-Meier yöntemine göre belirlenmiştir.

Bulgular: Ortanca yaş 51’dir (34-79 yaş). En sık endometrium-over kanser birlikteliği (16 hasta, %61.5) gözlenmiştir. Diğer multipl primer tümörler ise; endometrium-serviks (4 hasta,%15.3), serviks-over (3 hasta %11.5), serviks-vajina (2 hasta, %7.6) ve endometrium-over-serviks kanserli 1 olgu (%3.8) şeklindedir. En sık evre1 ve grad1 malignite gözlenmiştir. En sık yakınma düzensiz vajinal kanamadır. Endometrium-over kanser grubu için 5 yıllık genel sağkalım %83 olarak bulunmuştur.

Sonuç: Günlük pratikte sık karşılaşılmamakla birlikte jinekolojik organlarda multipl primer kanser görülebilir. Senkron endometrium ve over kanseri bu durumlar içinde en sık görülenidir. Göreceli olarak daha erken evrede saptandıkları için iyi prognoza sahiptir. Kanserde erken tanının prognoza olumlu etkisi düşünüldüğünde jinekolojik malignite tanısı almış olgularda ikinci bir kanser gelişme riski her zaman akılda tutularak, bu olguların takibinde daha dikkatli olunmalıdır.

Anahtar Kelimeler

• Multipl primer kanser
• senkron kanser
• metakron kanser

MULTIPLE PRIMARY GYNECOLOGIC TUMORS

Öz

Objective: To evaluate incidence, clinical and pathological features and survival of patients who had multiple gynecological tumors.

Material and methods: 2373 patients treated between 1992 and 2010 with gynecological malignancy were analyzed retrospectively. Multiple gynecological malignancy was observed in 26 (1.09%) patients. While 25 patients had two different malignancy, only one patient had three different primary cancer. Twenty-three patients had synchronous cancer and 3 patients developed metachronous cancer after 7, 22, and 24 years of treatment. 2009 FIGO staging system was used. Overall survival was analyzed by Kaplan-Meier method for endometrium-ovary group.

Results: The median age was 51 years (34-79 years). Coexistence of endometrial and ovary cancer was most common (61.5%). Other coexistence of malignancies were; endometrium-cervix (4 patients, 15.3%), cervix-ovary (3 patients, 11.5%), cervix-vagina (2 patients, 7.6%) and endometrium-over-cervix cancer (1 patient, 3.8%). The most common stage and grade were; stage1 and grade1. The most common complaint was abnormal vaginal bleeding. 5 year overall survival was 83% for endometrium-ovary group.

Conclusion: Multiple primary gynecological cancer is not common in daily practice. Synchronous endometrial and ovarian cancer is the most common in this population. They have a good prognosis due to detection at a relatively early stage. When we consider the positive impact of early diagnosis for its prognosis, the risk of developing a secondary cancer always should be kept in mind in the presence of a primary malignancy and follow-up of these patients should be done carefully.

Anahtar Kelimeler

• Multiple primary cancer
• synchronous cancer
• metachronous cancer

Kaynakça

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