Dil kanserli hastalarda preoperatif neoadjuvan kemoterapinin prognostik rolü

Abstract

Amaç: Bu çalışmanın amacı glossektomi uygulanan dil kanseri hastalarında preoperatif neoadjuvan kemoterapi (NAC) ile sağkalım arasındaki ilişkiyi araştırmaktı. Gereç ve Yöntem: Çalışmaya dil kanseri nedeniyle glossektomi uygulanan 35 hasta dahil edildi. Yirmi hasta ameliyat öncesi herhangi bir tedavi almadı (kontrol grubu). On beş hasta ameliyattan önce iki kür sisplatin içeren NAC aldı. Beş yıllık sağkalım bulguları gruplar arasında karşılaştırıldı. Bulgular: Medyan patolojik invazyon derinliği NAC grubunda kontrol grubuna göre daha düşüktü (7 vs 9 mm, p = 0.037). Mortalite oranı NAC grubunda daha düşüktü (%26.7 vs %50.0, p = 0.008). Artan invazyon derinliği, artan mortalite riskinin bağımsız belirteçleri olarak saptandı. Preoperatif NAC alımı ise azalan mortalite riskinin bağımsız bir belirteciydi. NAC grubunda mortalite riski kontrol grubuna göre 6,25 kat daha düşüktü (1/0,16) (HR: 0,16, %95 GA: 0,004-0,72, p = 0,017). Sonuç: Preoperatif NAC sonrası cerrahi uygulanan hastalar, tek başına cerrahi uygulanan hastalara kıyasla 5 yıllık sağkalımda anlamlı bir iyileşme gösterdi. Bu bulgular, dil kanserli hastaların prognozunda ameliyattan önce NAC'nin rolü için ilham verici olabilir.

Keywords

• invazyon derinliği
• neoadjuvan kemoterapi
• nüks
• prognoz
• dil kanseri

Prognostic role of preoperative neoadjuvant chemotherapy in patients with tongue cancer

Abstract

Aim: This study aimed to investigate the relationship between preoperative neoadjuvant chemotherapy (NAC) and overall survival in patients with tongue cancer who underwent glossectomy. Material and Method: The study included 35 tongue cancer patients who underwent glossectomy. Twenty patients did not receive any treatment before surgery (control group). Fifteen patients received two cycles of cisplatin-containing NAC prior to surgery. Five-year overall survival findings were compared between the groups. Results: Median pathological depth of invasion was lower in the NAC group compared to the control group (7 vs. 9 mm, p=0.037). The mortality rate was lower in the NAC group (26.7% vs. 50.0%, p=0.008). Increased depth of invasion was independently associated with increased risk of mortality, while receiving NAC was independently associated with decreased risk of mortality. The risk of mortality was 6.25-fold lower (1/0.16) in the NAC group compared to the control group (HR: 0.16, 95% CI: 0.004-0.72, p=0.017). Conclusion: Patients who underwent NAC plus surgery were associated with a higher probability of 5-year overall survival compared to patients who underwent surgery alone. These findings may be inspiring for the role of NAC prior to surgery in the prognosis of patients with tongue cancer.

Keywords

• Depth of invasion
• neoadjuvant chemotherapy
• prognosis
• tongue cancer

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