THE EFFECT OF TUMOR FREE DISTANCE ON THE PROGNOSTIC FACTORS OF ENDOMETRIAL CANCER

Öz

OBJECTIVE: We aimed to evaluate the importance of tumor-free distance (TFD) in prognostic factors of endometrial cancer (EC) and determine the best TFD cut-off value for predicting advanced EC. MATERIAL AND METHODS: This study included 153 patients diagnosed with EC. The depth of myometrial invasion (DOI) and TFD were measured, and the associations between prognostic factors for EC and DOI and TFD were evaluated. RESULTS: The mean ± standard deviation values of TFD and DOI were 12 ± 6 and 7 ± 6 mm, respectively. TFD and DOI were significantly related to lymph node (LN) metastasis, lymphovascular space invasion (LVSI) and cervical involvement. A shorter TFD was significantly associated with a higher tumor grade, positive cytology and LVSI. Shorter DOI was significantly associated with LN metastasis and cervical involvement. A receiver operating characteristics curve analysis demonstrated that the optimal TFD cut-off value was 48% for LN metastasis. A DOI of 47% had the best sensitivity and specificity for LN metastasis. CONCLUSIONS: TFD was superior for predicting LVSI as compared to DOI, whereas DOI showed good diagnostic performance for predicting LN metastasis. Further studies are needed to predict the effect of TFD and DOI on the prognostic factors of endometrial cancer.

Anahtar Kelimeler

• Endometrial cancer
• Lymphatic metastasis
• Myometrium
• Prognosis.

ENDOMETRiYAL KANSERİN PROGNOSTiK FAKTÖRLERİ ÜZERİNDE TÜMÖRSÜZ MESAFENİN ETKİSİ

Öz

AMAÇ: Endometrial kanserin (EK) prognostik faktörlerinde tümörsüz mesafenin (TFD) önemini değerlendirmeyi ve ileri evre EK'ni öngörmek için en iyi TFD cut-off değerini belirlemeyi amaçladık. GEREÇ VE YÖNTEM: Bu çalışmaya EK tanısı alan 153 olgu dahil edildi. Myometriyal invazyonun derinliği (DOI) ve TFD ölçüldü ve EK için prognostik faktörler ile DOI ve TFD arasındaki ilişkiler değerlendirildi. BULGULAR: TFD ve DOI'nin ortalama ± standart sapma değerleri sırasıyla 12 ± 6 ve 7 ± 6 mm olarak hesaplandı. TFD ve DOI, lenf nodu (LN) metastazı, lenfovasküler alan invazyonu (LVSI) ve servikal tutulum ile anlamlı şekilde ilişkiliydi. Daha kısa TFD, daha yüksek tümör grade, pozitif sitoloji ve LVSI ile anlamlı şekilde ilişkiliydi. Daha kısa DOI, LN metastazı ve servikal tutulum ile anlamlı şekilde ilişkiliydi. ROC eğrisi analizinde, LN metastazı için optimal TFD cut-off değerinin %48 olduğunu gösterildi ve %47'lik DOI, LN metastazı için en iyi sensitivite ve spesifiteye sahipti. SONUÇ: TFD, DOI ile karşılaştırıldığında LVSI'yi öngörmede daha üstün iken DOI, LN metastazını öngörmede iyi bir tanısal performans gösterdi. Endometriyal kanserin prognostik faktörleri üzerinde TFD ve DOI’nin etkisini öngörmede daha fazla çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Endometrial kanser
• Lenfatik metastaz
• Miyometrium
• Prognoz

Kaynakça

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