Endometrioid Tip Adenokanserde Prognostik Faktörlerin Sağkalıma Etkisi

Öz

Amaç: Uterusun endometrioid tip adenokanserlerinde prognostik faktörlerin sağ kalıma etkisini saptamayı amaçladık. Materyal ve Metot: Kliniğimizde 2006 Mayıs- 2012 Mayıs arasında endometrium kanseri nedeniyle cerrahi tedavi uygulanan histolojik tipi Endometrioid Adenokarsinom olan 144 olgu çalışmaya dahil edildi. Demografik veriler ve tümör özelliklerinin lenf nodu metastazı ve sağ kalıma ilişkisi değerlendirildi. Evre I grade 1-2 tümörler lenfadenektomi yapılanlar ve yapılmayanlar olarak gruplandırılarak 5 yıllık sağ kalım değerlendirildi. Bulgular: Miyometriyal invazyonun >1/2 den fazla olmasının, adneksiyal tutulumun ve lenfovasküler alan invazyon varlığının lenf nodu metastazı ile ilişkili olduğu izlenmiştir (p=0,010, 0,019 ve 0,015). 5 yıllık sağ kalım %87,4 olarak bulunmuştur. Yaş, miyometriyal invazyon ve tümorün gradenin sağ kalım ile ilişkili olduğu gözlenmiştir. 5 yıllık sağ kalım lenfadenektomi yapılan grupta %89,8, lenfadenektomi yapılmayan grupta ise %85,2 olarak hesaplanmıştır ve aralarında istatistiksel olarak anlamlı bir fark izlenmemiştir (p=0,575). Sonuç: Miyometriyal invazyon, adneksiyal tutulum ve lenfovasküler alan invazyon varlığının önemli birer prognostik faktör olduğunu belirledik. Evre I grade 1-2 tümörlerde lenfadenektominin sağ kalımı arttırmadığını saptadık. Evre I grade 1-2 tümör varlığında lenfadenektomi yapılmayabilir. Böylece lenfadenektominin hastaya yükleyeceği morbiditeden kaçınılabilir.

Anahtar Kelimeler

• Endometrium kanseri
• lenfadenektomi
• prognostik faktör

The Effect of Prognostic Factors on Survival in Endometrioid Type Adenocancer

Öz

Objective: The study aims to investigate the prognostic factors in uterine endometrioid adenocarcinoma that affect survival outcomes. Materials and Methods: This retrospective study includes 144 cases which underwent surgical treatment for uterine endometrioid adenocarcinoma. Demographic data and tumour characteristics were evaluated for lymph node metastasis. Stage I and grade 1-2 tumours were divided into lymphadenectomy and non-lymphadenectomy groups, and 5-year survival was assessed. Results: The presence of myometrial invasion of more than 1/2, adnexal metastasis and lymphovascular space invasion were found to be associated with lymph node metastasis (p=0.010 ve 0.019 ve 0.015). In our study, the 5-year survival rate was 87.4%. Survival rate was correlated with age, myometrial invasion, and tumour grade. The 5-year survival rates were 89.8% in lymphadenectomy group and 85.2% in non-lymphadenectomy group, and no statistically significant difference was observed (p=0.575). Conclusion: Myometrial invasion, grade and the age of diagnosis were detected as important prognostic factors of uterine endometrioid adenocarcinomas. We concluded that lymphadenectomy did not increase the survival rate of stage I grade 1-2 endometrioid tumours. Lymphadenectomy may not be performed in stage I grade 1-2 tumours; thus, the morbidities of lymphadenectomy can be avoided.

Anahtar Kelimeler

• Endometrial cancer
• lymphadenectomy
• prognostic factors

Kaynakça

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