HİGH GRADE SERÖZ OVER KANSERİ TANISINDA ULTRASON EŞLİĞİNDE TRUCUT İĞNE BİYOPSİSİ VE LAPAROSKOPİNİN KARŞILAŞTIRILMASI

Yıl 2025, Cilt: 26 Sayı: 1, 5 - 9, 27.01.2025

Cem Yağmur Özdemir , Dağhan Arda Arıöz , Nayif Çiçekli , Betül Ahat , Hüseyin Çoşkun , Hacer Demir , Öznur Öner , Dağıstan Tolga Arıöz

https://doi.org/10.18229/kocatepetip.1514488

Öz

AMAÇ: Kliniğimizde high grade seröz over kanseri (HGSC) tanısında
tru-cut biyopsi ile laparoskopiyi karşılaştırmayı amaçladık.
GEREÇ VE YÖNTEM: Retrospektif olarak tasarlanan çalışmamıza
Ocak 2013 ile Aralık 2023 tarihleri arasında HGSC tanısıyla
opere edilen hastalar dahil edildi. Patolojik olarak doğrulanmış
(FIGO 2018) evre III veya IV HGSC hastalarına neoadjuvan kemoterapi
(NACT) ve ardından interval debulking cerrahisi (IDS)
uygulandı. Hariç tutma kriterleri, evre I ve II over kanseri olguları
ve NACT almayan hastalardı. Ayrıca non-HGSC veya non-jinekolojik
olgular çalışma dışı bırakıldı. Sonuç olarak çalışmaya 60
hasta dahil edildi. Katılımcılar iki gruba ayrıldı; grup 1 (NACT
öncesi tru-cut biyopsi ile HGSC tanısı alan hastalar) ve grup 2
(NACT öncesi tanısal laparoskopi ile HGSC tanısı alan hastalar).
Sağkalım analizleri, Kaplan Meier ve log-rank testi kullanılarak
yapıldı. İstatistiksel anlamlılık p <0.05 olduğunda tanımlandı.
BULGULAR: 60 hastanın 32'sine tru-cut biyopsi, 28'ine laparoskopi
ile tanı konuldu. Grup 1'in genel sağkalım oranı (OS) %53,1
ve grup 2 için %71,4 idi (p = 0,371). Progresyonsuz sağkalım
(PFS) oranı grup 1 için 56,3 ve grup 2 için %64,3 idi (p = 0,464).
Nüks, OS ve PFS açısından iki grup arasında anlamlı fark saptanmadı.
Grup 1 ile grup 2 arasında sadece hastanede kalış süresi
açısından anlamlı fark bulduk (p<0,001).
SONUÇ: HGSC, tanısı ve tedavisi zor olan over kanserinin histopatolojik
bir alt grubudur. İleri evre over kanserinde primer debulking
cerrahisi güncel yaklaşımda geri planda kalırken, hastaların
tanısal değerlendirmesinde tru-cut biyopsinin hastanede
kalış süresinin kısa olması açısından önemi unutulmamalıdır.

Anahtar Kelimeler

High Grade Seröz Over Kanseri, Laparoskopi, Sağkalım, Tru-cut Biyopsi.

Proje Numarası

n/a

COMPARISON OF ULTRASOUND-GUIDED TRUCUT NEEDLE BIOPSY AND LAPAROSCOPY IN THE DIAGNOSIS OF HIGH-GRADE SEROUS OVARIAN CANCER

Öz

OBJECTIVE: We aimed to compare tru-cut biopsy with laparoscopy
in the diagnosis of high-grade serous ovarian cancer
(HGSC) in our clinic.
MATERIAL AND METHODS: Our retrospective study included
patients who underwent surgery for HGSC between January
2013 and December 2023. Patients with pathologically confirmed
(FIGO 2018) stage III or IV HGSC underwent neoadjuvant
chemotherapy (NACT) and interval debulking surgery (IDS)
were performed. Exclusion criteria were patients with stage
I and II ovarian cancer and who did not receive NACT. Additionally,
patients with non-high-grade serous ovarian cancer or
non-gynecological conditions were excluded. As a result, 60
patients were included in the study. Participants were categorized
into two groups, namely, Group 1 (Patients diagnosed with
HGSC by tru-cut biopsy before NACT) and Group 2 (Patients diagnosed
with HGSC by diagnostic laparoscopy before NACT).
Time-to-event analyses were conducted using the Kaplan- Meier
method and log-rank test. Statistical significance was defined
when p < 0.05.
RESULTS: Out of the 60 patients, 32 patients were diagnosed
by tru-cut biopsy and 28 patients with laparoscopy. The overall
survival (OS) of Group 1 was 53.1%, and for Group 2, it was
71.4% (p = 0.371). The progression-free survival (PFS) rate was
56.3 for Group 1 and 64.3% for Group 2 (p = 0.464). No significant
difference was detected in terms of recurrence, OS and
PFS. We found a significant difference between Group 1 and
Group 2 only in terms of hospitalization time (p < 0.001).
CONCLUSIONS: HGSC is a histopathological subgroup of ovarian
cancer that is difficult to diagnose and manage. While primary
debulking surgery remains in the background, the importance
of tru-cut biopsy in terms of short hospital stay should
not be forgotten in the diagnostic evaluation of patients.

Anahtar Kelimeler

High- Grade Ovarian Carcinoma, Laparoscopy, Survival, Tru-cut Biopsy.

Etik Beyan

The present study was approved by the Ethical Committee of Afyonkarahisar Health Sciences University Hospital (grant no: 2024/3) and the research was continued in accordance with the Declaration of Helsinki. Informed consent was obtained from all patients during their hospitalization.

Destekleyen Kurum

This research received no external funding.

Proje Numarası

n/a

Teşekkür

We would like to thank Saygin Alkan and Nagihan Ozdemir for the figure edits.

Kaynakça

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