ENDOMETRİUMLA SINIRLI YA DA MYOMETRİUMUN YARISINA KADAR İNVAZYONU OLAN ENDOMETRİOİD TİP ENDOMETRİAL ADENOKARSİNOM: OPERASYON TİPİNİN SAĞKALIM ÜZERİNE ETKİSİ
Öz
Amaç: Endometriumla s›n›rl› ya da myometriumun yar›s›na
kadar invazyonu olan endometrioid tip grade 1 endometrial adenokarsinom
vakalar›nda lenf nodu örneklemesinin sa¤kal›m oranlar›
üzerindeki etkisini araflt›rmak.
Materyal ve Metod: 1993-1998 y›llar› aras›nda endometrioid
tip grade 1 endometrial adenokarsinom tan›s› ile opere edilen tüm
hastalar›n medikal kay›tlar› incelendi. Frozen section patoloji sonucuna
göre Total Abdominal Histerektomi (TAH) + Bilateral
Salpingo-ooforektomi (BSO) + Omental Biopsi (OB) + Peritoneal
Sitolojik Örnekleme (PCS) (Grup A) ya da TAH + BSO + OB +
PCS + Lenf Nodu Örneklemesi (LNS) (Grup B) yap›lan endometriumla
s›n›rl› ya da myometriumun yar›s›na kadar invazyonu olan
endometrioid tip grade 1 endometrial adenokarsinom olgusu çal›fl-
maya dahil edildi. Hastalar›n yafl›, menopozal durumlar›, tümör
karakteristikleri ve rekürrensler not edildi.
Bulgular: Seksenbir olgu çal›flmaya dahil edildi. Grup A’da 62
hasta, Grup B’de 19 hasta vard›. Her iki grup ortalama yafl, gravida,
vücut kütle indeksi (BMI) ve menopozal durum aç›s›ndan benzerdi.
Her grupta bir rekürrens meydana geldi. Tümör Grup A’da
jejunumda, Grup B’de vajinal güdükte nüksetti. Rekürrens oranlar›
istatistiksel olarak farkl› de¤ildi. Grup A’da hiç ölüm olmazken,
Grup B’de 5 ölüm oldu ancak bunlar›n hiçbiri kansere ba¤l› ölümler
de¤ildi. Befl- ve 10-y›ll›k toplam sa¤kal›m oranlar› Grup A’da
Grup B’ye göre anlaml› olarak yüksekti (p<0.05) ancak 5- ve 10-
y›ll›k hastal›ks›z sa¤kal›m oranlar› benzerdi.
Sonuç: Histerektomi + Lenf nodu örneklemesi yap›lan hastalarla
sadece histerektomi yap›lan hastalar›n toplam sa¤kal›m oran›
ayn› idi. Endometrial adenokarsinomda lenf nodu örneklemesi evrelendirmenin
do¤ru yap›labilmesini sa¤lad›¤› için de¤erlidir ancak
frozen section patoloji sonucuna göre endometriumla s›n›rl› ya
da myometriumun yar›s›na kadar invazyonu olan endometrioid tip
grade 1 endometrial adenokarsinom olgular›nda toplam sa¤kal›m
ve rekürrens oranlar›na etkisi yok gibi gözükmektedir
Anahtar Kelimeler
Erken evre endometrial adenokarsinom Lenf nodu örneklemesi Sağkalım
Öz
Objective: To determine the impact of lymph node sampling on
survival rates in endometrioid type grade 1 endometrial adenocarcinoma
confined to the endometrium or with less than inner half
myometrial invasion.
Materials and Method: Medical reports of all patients treated
for endometrioid type grade 1 endometrial adenocarcinoma between
1993-1998 at the Department of Gynecologic Oncology were reviewed.
Patients who had endometrioid type endometrial adenocarcinoma
confined to the endometrium or with less than inner half
myometrial invasion as determined by frozen section and underwent
Total Abdominal Hysterectomy (TAH) + Bilateral Salpingooophorectomy
(BSO) + Omental Biopsy (OB) + Peritoneal Cytologic
Sampling (PCS) (Group A) or TAH + BSO + Lymph Node
Sampling (LNS) + OB + PCS (Group B) were included in the
study. Patients’ age, menopausal status, tumor characteristics and
recurrences were noted.
Results: Eighty-one patients were included in the study. There
were 62 patients in Group A and 19 patients in Group B. Both groups
were similar in terms of mean age, gravida, BMI and menopausal
status. There was one recurrence in each group. The tumor recurred
in jejunum in Group A and in the vaginal stump in Group B.
Recurrence rates were not statistically different. None of the patients
died in Group A, while 5 patients died in Group B, although
this difference was statistically significant, the five patients in Group
B had died disease-free. Five- and 10-year overall survival rates
were significantly higher in Group A when compared with Group
B (p<0.05) but 5- and 10-year diease-free survival rates were similar
in both groups.
Conclusion: The survival rate for patients who underwent
hysterectomy + lymph node sampling was similar to that of patients
who underwent only hysterectomy. Lymph node sampling in endometrial
adenocarcinoma is worthwhile as it allows staging to be
performed properly, nevertheless it seems to have no effect on
overall and disease-free survival rates and recurrence rates when
the disease is grade 1 and confined to the endometrium or there is
less than inner myometrial invasion as determined by frozen section.
Anahtar Kelimeler
Early stage endometrial adenocarcinoma Lmyph node sampling Survival
Ayrıntılar
| Diğer ID | JA49AA35TZ |
|---|---|
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Nisan 2005 |
| Gönderilme Tarihi | 1 Nisan 2005 |
| Yayımlandığı Sayı | Yıl 2005 Cilt: 8 Sayı: 2 |