Nöroendokrin tümörlü hastaların retrospektif değerlendirilmesi
Küçük Resim Yok
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Nöroendokrin karsinomlar, yüksek gradlı ve az diferansiye tümörlerdir. Mortalite oranı yüksek olan bu tümörlerin yaklaşık %60'ı gastroenteropankreatik yerleşim gösterirken %40 gastrointestinal sistem dışında yerleşim gösterir. Sitotoksik tedavide yıllarca farklı kemoterapi rejimleri kullanılsa da özellikle kötü diferansiye nöroendokrin karsinomda platin bazlı rejimler ön plana çıkmaktadır. Çalışmamıza akciğer dışı az diferansiye nöroendokrin tümör tanısı alan, 18 yaş üstü toplam 45 hasta dahil edildi. Akciğer yerleşimli nöroendokrin tümör olması, akciğer dışı grad 1 veya grad 2 nöroendokrin tümör olması, 18 yaş altı hasta grubu ve senkron malignite varlığı dışlanma kriterleri olarak kabul edildi. Hastaların dosya kayıtları ve patoloji raporları incelendi. Demografik, klinik, laboratuvar ve patoloji özellikleri kayıt edildi. Progresyonsuz sağ kalım ve genel sağ kalım süreleri hasta dosyalarından alındı. Hastaların yaş ortalaması 60±14 (min.-maks.= 36-90 ) olup, erkek/kadın cinsiyet oranı 2.2 idi. Primer lezyonların yerleşim yerleri sırasıyla pankreas (%24,5), mide (%17,9), mesane (%13,3), ince barsak (%4,4), safra kesesi (%4,4), kolorektal (%4,4), prostat (%4,4), serviks (%2,2), özefagus (%2,2), meme (%2,2) ve böbrek (%2,2) iken, hastaların %17,9'unun primer yerleşim yeri bilinmiyordu. Karın ağrısı (%58) en sık başvuru semptomunu oluştururken, primer lezyona yönelik cerrahi işlem 12 hastada yapıldı. Sağ kalım ile ilişkili klinik ve laboratuvar değişkenler univariate analiz edildiğinde, platin-bazlı tedavi (HR=0.070, %95 GA= 0.020 – 0.250, p<0.001), anlamlı olarak saptandı. Platin-bazlı kemoterapi genel sağ kalımı belirleyen en önemli faktör olarak tespit edildi. Az diferansiye nöroendokrin tümörlerin, prognostik faktörlerinin daha kapsamlı değerlendirilmesi için daha geniş populasyonlu, prospektif, randomize klinik çalışmalara ihtiyaç duyulmaktadır. Anahtar kelimeler: Nöroendokrin tümör, platin-bazlı tedavi, ki-67
RETROSPECTIVE ASSESSMENT OF PATIENTS WITH NEUROENDOCRINE TUMOUR SUMMARY Neuroendocrine carcinomas are high grade and low differential tumors. Approximately 60% of these tumors with a high mortality rate show gastroenteropancreatic localization and 40% are located outside the gastrointestinal tract. Although different chemotherapy regimens have been used for years in cytotoxic therapy, platinum based regimens predominate especially in poorly differentiated neuroendocrine carcinoma. A total of 45 patients, aged 18 years or older, who were diagnosed as non-pulmonary neuroendocrine carcinoma were included. The presence of pulmonary neuroendocrine tumors was considered as extracorporeal grade 1 or grade 2 neuroendocrine tumors, patients under 18 years of age and synchronous malignancy presence exclusion criteria. Patient's file records and pathology reports were examined. Demographic, clinical, laboratory and pathological features were recorded. Progression-free survival and overall survival were obtained from patient files. Findings: The mean age of the patients was 60 ± 14 (min-max = 36-90) and male / female sex ratio was 2.2. The primary sites of the lesions were pancreas (24.5%), stomach (17.9%), bladder (13.3%), small intestine (4.4%), bile duct (4.4%), colorectal (2.2%), esophagus (2.2%), breast (2.2%) and kidney (2.2%), while 17.9% of the patients had no known primary site. While abdominal pain (58%) was the most common symptom, surgical treatment for primary lesion was performed in 12 patients. Platinum-based treatment (HR = 0.070, 95% GA = 0.020-0.250, p <0.001) was found to be significant when clinical and laboratory variables associated with survival were analyzed univariate. Platinum-based chemotherapy was the most important determinant of overall survival. Prospective, randomized clinical trials with broader populations are needed for a more comprehensive assessment of prognostic factors of neuroendocrine carcinoma. Key words: Neuroendocrine tumour, platinum-based therapy, ki-67
RETROSPECTIVE ASSESSMENT OF PATIENTS WITH NEUROENDOCRINE TUMOUR SUMMARY Neuroendocrine carcinomas are high grade and low differential tumors. Approximately 60% of these tumors with a high mortality rate show gastroenteropancreatic localization and 40% are located outside the gastrointestinal tract. Although different chemotherapy regimens have been used for years in cytotoxic therapy, platinum based regimens predominate especially in poorly differentiated neuroendocrine carcinoma. A total of 45 patients, aged 18 years or older, who were diagnosed as non-pulmonary neuroendocrine carcinoma were included. The presence of pulmonary neuroendocrine tumors was considered as extracorporeal grade 1 or grade 2 neuroendocrine tumors, patients under 18 years of age and synchronous malignancy presence exclusion criteria. Patient's file records and pathology reports were examined. Demographic, clinical, laboratory and pathological features were recorded. Progression-free survival and overall survival were obtained from patient files. Findings: The mean age of the patients was 60 ± 14 (min-max = 36-90) and male / female sex ratio was 2.2. The primary sites of the lesions were pancreas (24.5%), stomach (17.9%), bladder (13.3%), small intestine (4.4%), bile duct (4.4%), colorectal (2.2%), esophagus (2.2%), breast (2.2%) and kidney (2.2%), while 17.9% of the patients had no known primary site. While abdominal pain (58%) was the most common symptom, surgical treatment for primary lesion was performed in 12 patients. Platinum-based treatment (HR = 0.070, 95% GA = 0.020-0.250, p <0.001) was found to be significant when clinical and laboratory variables associated with survival were analyzed univariate. Platinum-based chemotherapy was the most important determinant of overall survival. Prospective, randomized clinical trials with broader populations are needed for a more comprehensive assessment of prognostic factors of neuroendocrine carcinoma. Key words: Neuroendocrine tumour, platinum-based therapy, ki-67
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Onkoloji, Oncology
