Çoklu primer tümörlü hastaların demografik, klinik, patolojik özelliklerinin değerlendirilmesi ve prevelansının saptanması
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çoklu primer tümörler, aynı hastada eş veya farklı zamanlarda birbirinden farklı olarak gelişen tümörlerdir. Tıp literatüründe tüm karsinomların % 0.7 -% 11 ’i oranında bildirilmektedir. Çoklu primer tümörler genel olarak iki grupta incelenir. İkinci tümör ilk tümör tanısından 6 ay sonra saptanırsa metakron, 6 ay içinde saptanırsa senkron tümör olarak isimlendirilir. Maligniteli olgularda ikinci primer tümör tanısı alabilmesi için Warren and Gates kriterleri geliştirilmiştir. Tümörlerin histolojik olarak malign olduğu ispat edilmelidir. İki tümör arasında en az 2 cm sağlam doku olmalı eğer aynı lokalizasyonda ise aralarında en az 5 yıl zaman geçmelidir. Metastatik hastalık ekarte edilmelidir. Bu çalışmadaki amacımız Trakya Üniversitesi Tıbbi Onkoloji Bilim Dalı’nda izlenen, tedavi ve takibi yapılan çoklu primer tümörlü hastaların klinik, demografik ve patolojik özelliklerini gözden geçirmek, prevelansını saptamak, literatür bulguları ile karşılaştırmak ve çoklu primer tümörlere yaklaşımımızı değerlendirmek ve iyileştirmekti. Çalışmaya Trakya Üniversitesi Tıp Fakültesi Hastanesinde 2005 ile 2015 yılları arasında çoklu primer tanısı almış 170 hasta dahil edildi. Hastaların verilerine patoloji raporlarından ve hasta dosya kayıtlarından ulaşıldı. Sağkalım hesapları Kaplan-Meier yöntemi ile yapıldı. Parametrik olmayan değişkenlerin birbiri ile ilişkileri Ki-kare test ile araştırıldı. Parametrik değişkenlerin gruplar arası karşılaştırması student testi ile yapıldı. Merkezimizideki çoklu primer tümörler metakron tümör ağırlıktaydı. Erkek hastaların sayısı kadınlardan fazla tespit edildi. Senkron tümörlerde iki tümör arasındaki ortanca süre 3 ay iken metakron tümörlerde 26 ay olarak saptandı. En çok birliktelik gösteren senkron tümörler akciğer-larenks ve akciğer-kolon iken metakron tümörler akciğer-mesane, akciğerlarenks, meme-endometrium ve meme-kolon idi. Sigara ve alkol hikayesi erkek hastalarda ve senkron tümörlerde daha yüksek saptandı. Tümör birliktelik durumu, birinci tümörün evresi ve birinci tümör tedavisi sağkalım açısından anlamlı saptandı. Sigara öyküsü, squamöz hücre histolojisi ve erkek cinsiyet istatistiksel anlamlı olmasa da sağkalımı olumsuz etkilediği saptandı.
abstract
Multiple primary tumors are the tumors which are different and can be present in a patient at the same or different times. Their prevelance is %0.7 -%11 in the literature. Multiple primary tumors are divided into two groups. Second tumor is named as metachronous if it is detected after 6 months of primary tumor diagnosis and it is named synchronous if it is detected in 6 months. Warren and Gates criteria is used for diagnosis of second primary tumor in malignancy patients. Their malignancy must be prooved histologically. Between two tumors the must be at least 2 cm healthy area and if they are at same localization there must be at least 5 years between them. Metastatic disease must be excluded. The aim of us in this study was to detect the prevelance and overview the clinical,pathological and demographic features of the patients who have multiple primary tumors , treated and followed in Trakya University Medical Faculty Medical Oncology Department and make comparison with literature findings. We also aimed to evaluate and improve our approach to multiple primary tumors. 170 patients who have multiple primary tumor diagnosis between 2005 and 2015 in Trakya University Medical Faculty Hospital are included in our study. We got the data from pathology reports and patients’ s files. Kaplan- Meier method was used for survival analyses. Chi-square test was used for detection of the relation of nonparametric variables to each other. Student test was used for comparison of parametric variables between groups. Most of our multiple primary tumors were metachronous. Men patients are more than women patients. While median time was 3 months between two tumors in synchronous tumors, it was 26 months in metachronous ones. While the synchronous tumors which have coexistance were lung-larynx and lung-colon the metachronous tumors which have coexistance were lung-bladder, lung, larynx, breast- endometrium and breast-colon. Cigarette smoking and alcohol insumption were more common in men and patients with synchronous tumors. Coexistance of tumors, stage of primary tumor, treatment of primary tumor were significant for survival. Cigarette smoking, squamous cell histology, men gender were found to effect the survival negatively while it is not statistically significant.
abstract
Multiple primary tumors are the tumors which are different and can be present in a patient at the same or different times. Their prevelance is %0.7 -%11 in the literature. Multiple primary tumors are divided into two groups. Second tumor is named as metachronous if it is detected after 6 months of primary tumor diagnosis and it is named synchronous if it is detected in 6 months. Warren and Gates criteria is used for diagnosis of second primary tumor in malignancy patients. Their malignancy must be prooved histologically. Between two tumors the must be at least 2 cm healthy area and if they are at same localization there must be at least 5 years between them. Metastatic disease must be excluded. The aim of us in this study was to detect the prevelance and overview the clinical,pathological and demographic features of the patients who have multiple primary tumors , treated and followed in Trakya University Medical Faculty Medical Oncology Department and make comparison with literature findings. We also aimed to evaluate and improve our approach to multiple primary tumors. 170 patients who have multiple primary tumor diagnosis between 2005 and 2015 in Trakya University Medical Faculty Hospital are included in our study. We got the data from pathology reports and patients’ s files. Kaplan- Meier method was used for survival analyses. Chi-square test was used for detection of the relation of nonparametric variables to each other. Student test was used for comparison of parametric variables between groups. Most of our multiple primary tumors were metachronous. Men patients are more than women patients. While median time was 3 months between two tumors in synchronous tumors, it was 26 months in metachronous ones. While the synchronous tumors which have coexistance were lung-larynx and lung-colon the metachronous tumors which have coexistance were lung-bladder, lung, larynx, breast- endometrium and breast-colon. Cigarette smoking and alcohol insumption were more common in men and patients with synchronous tumors. Coexistance of tumors, stage of primary tumor, treatment of primary tumor were significant for survival. Cigarette smoking, squamous cell histology, men gender were found to effect the survival negatively while it is not statistically significant.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Çoklu Primer Tümör, Metakron, Senkron, Sağkalım, Multiple Primary Tumor, Survival, Metachronous
