SERVİKS KANSERİNDE PRİMER KEMORADYOTERAPİ SONRASI UTERUSTA SINIRLI REZİDU TÜMÖRÜN SAĞKALIMA OLAN ETKİSİ

Yıl 2018, Cilt: 49 Sayı: 4, - , 15.12.2018

Hamdullah Sözen , Merve Baktıroglu Harika Yumru İrem Usta İbrahim Yalçın Seden Kucucuk Kamuran Ibıs Samet Topuz , Yavuz Salihoglu

https://doi.org/10.16948/zktipb.487978

Öz

ÖZET:

Amaç: Primer kemoradyoterapi
tedavisi almış ileri evre serviks kanserli hastalarda uterusa sınırlı rezidü
tümör miktarının sağkalıma etkisini belirlemek ve bu tarz tümörlerde görüntüleme
yöntemlerinin rezidü tümör saptamadaki başarısı saptamak

Materyal Metod: İstanbul
Universitesi İstanbul Tıp Fakültesi Jinekolojik Onkoloji Kliniğinde 2009 Nisan-2017
Mayıs ayları arasında opere edilen 31 hasta çalışmaya dahil edilmiştir. Bu
hastaların klinikopatolojik özellikleri değerlendirilmiştir. Hastalar operasyon
öncesi Magnetik Rezonans inceleme (MRI) ve/veya Pozitron Emisyon Tomografi
(PET-BT) ile değerlendirilmiştir. Hastalar operasyon sonrası uterus
materyalinde tümör miktarına göre i) rezidu tümör yok ii) rezidü tümör <10
mm iii) rezidü tümör > 10 mm olarak üç gruba ayrılmış ve  hastalıksız sağkalım incelemesi yapılmıştır.

Sonuçlar: Ortanca yaş
54 olarak hesaplanmıştır. MRI rezidü tümör saptamada sensitivitesi %75
spesifitesi %50 ; PET-BT  sensitivitesi
%54.5 spesifitesi %50 olarak saptanmıştır. Bir yıllık hastalıksız sağkalım
oranları rezidü olmayan, mikroskobik rezidü olan ve makroskobik rezidü olan
hastalarda sırası ile %92.3, %80 ve %38.5 olarak tespit edildi.

Yorum: Irradiye serviks kanserinde rezidü tümör saptamada
görüntüleme yöntemlerinin başarısı kısıtlıdır. Histopatolojik olarak saptanmış
rezidü tümörün büyüklüğü arttıkça hastalıksız sağkalım rakamları azalmaktadır.

Anahtar Kelimeler

SERVİKS KANSERİ, RADYOTERAPİ

The survival effect of residual disease on hysterectomy specimen among the patients previously treated by chemoradiotherapy

Öz

Aim: to determine the association between the life
prospects and residual tumour size on hysterectomy specimen among the group of
patients previously treated by primary chemoradiotherapy. Secondary aim of the
study is to investigate the success of imaging methods on the same group of
patients
Materials
methods: thirty one patients operated
at istanbul university istanbul medical faculty between 2009 april and 2017
october  due to insuffient treatment after primary chemoradiotherapy are
recruited. Clinicopatholigical features of these patients were evaluated.
Patients are categorized according to residual tumour size on hysterectomy
specimen i) no residual tumour in specimen ii) residual tumour size under 10 mm
iii) residual tumour size more than 10 mm
Results: Median age is calculated as 54 . Sensitivity and
specifity of magnetic resonance investigation are found 75 percent and 50
percent whereas pozitron emission tomography sensitivity and specifity are
calculated as 54 and 50 percent respectively. One year disease free survival of
no tumour group, microscopic tumour group and macroscopic tumour group are
calculated 92 , 80, 38 percent, respectively
Conclusion: The success of imaging methods on determining
residual tumour in uterus is limited. Increasing size of residual tumour proven
by histopathological method on uterus is associated with worse prognosis

Anahtar Kelimeler

chemoradiotherapy, cervical canser

Kaynakça

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