Primeri bilinmeyen tümörlerin klinik, patolojik, demografik özellikleri ve tedavi sonuçlarının retrospektif analizi
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Dosyalar
Tarih
2012
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda primeri bilinmeyen kanser oranı %2.1 bulundu. Sigara içen hastaların oranı %59 idi. Olası primer akciğer ile sigara kullanma arasında anlamlı (p=0.020) ilişki bulundu. Olası primer ile sigara kullanma arasında anlamlı (p=0.006) ilişki bulundu. Hastaların en sık metastaz yeri karaciğer idi. Ortanca metastaz bölge sayısı 2 idi. Ortanca karaciğer metastaz sayısı 4, karaciğer metastazı olan hastaların sağkalım sonuçları, karaciğer metastazı olmayan diğer hastaların sağkalım sonuçlarından belirgin şekilde kötü bulundu (p=0.001). En sık histolojik tanı %63 ile adenokarsinomdu. En sık olası primer %36 ile akciğer öngörüldü. Çalışmamızda ortanca genel sağkalım 6 ay idi. Sağkalım sonuçları açısından olası primer öngörülenlerle öngörülemeyenler karşılaştırıldığında ortanca sağkalım 6 aya karşı 4 ay bulundu (p=0.08). Olası over, testis ve primer periton tümörleri gibi kemosensitif grup diğer tümörlerle karşılaştırıldığında ortanca sağkalım 11 aya karşı 6 ay bulundu (p=0.036). Sitokeratin7 pozitifliği ile olası primeri akciğer olarak öngörülen hastalar arasında anlamlı ilişki bulundu. Akciğer kanseri öngörüsünde bulunulan hastalarda sitokeratin20 pozitifliği anlamlı olarak düşük bulundu (p:0.002). Alkali fosfataz, hemoglobin, albümin, laktat dehidrogenaz, kemoterapi yanıtı ve karaciğer metastazı tek değişkenli analizde sağkalımla ilişkili bulundu, fakat çok değişkenli analizde sadece karaciğer metastazı varlığı ve kemoterapiye yanıt sağkalımla ilişkili bulundu. Olası primerin öngörülmesi ile öngörülememesinin sağkalımı etkilemediği görüldü, kemosensitif grubun identifiye edilmesi sağkalım sonuçlarını iyileştirmektedir. Anahtar Kelimeler: Primeri bilinmeyen kanser, prognoz, kemoterapi, sağkalım
Abstract
In our study the rate of cancer with an unknown primary site was found to be 2.1%. 59% of the patients included in the study were smokers. A significant relationship was found between smoking and the lung as a potential primary site (p = 0.020). A significant relationship was also found between smoking and the potential primary site (p = 0.006). The liver was the most frequent site of metastasis in most patients. While the median number of metastasis sites was 2, the median number of liver metastasis observed was 4. Survival rates were remarkably worse among patients with liver metastasis compared to those patients without liver metastasis (p = 0,001). The most frequent histologic diagnosis was adenocarcinoma (63%). The most potential primary site was the lung with a rate of 36%. In our study the median survival rate was 6 months. When those sites assigned and those not assigned as primary were compared in terms of survival time the median period was found to be 6 months against 4 months (p=0.08). When the chemosensitive group including potential tumors of the ovary, testis and periton was compared with the other tumors the median survival rate was found to be 11 months against 6 months (p=0.036). When chemosensitive tumors were excluded from potential primary tumors the difference in median survival time was found to be 6 months among those with a potential primary site and 4 months among those whose potential primary site was unknown (p =0,12). Positive serokeratin 20 was found to be significantly lower in patients with potential lung cancer (p =0,002). According to results of univariate analysis survival rates are associated with alkaline phosphatase, hemoglobin, lactate dehidrogenase response to chemotherapy and liver metastasis. However in multivariate analysis survival rates were found to be only associated with liver metastasis and response to chemotherapy. It was found that the survival rate was not affected by those assigned and those not assigned as potential primary sites. Identification of the chemosensitive group will help in improving the rates of survival. Key words : Cancer of unknown primary, prognosis, chemotherapy, survival
Abstract
In our study the rate of cancer with an unknown primary site was found to be 2.1%. 59% of the patients included in the study were smokers. A significant relationship was found between smoking and the lung as a potential primary site (p = 0.020). A significant relationship was also found between smoking and the potential primary site (p = 0.006). The liver was the most frequent site of metastasis in most patients. While the median number of metastasis sites was 2, the median number of liver metastasis observed was 4. Survival rates were remarkably worse among patients with liver metastasis compared to those patients without liver metastasis (p = 0,001). The most frequent histologic diagnosis was adenocarcinoma (63%). The most potential primary site was the lung with a rate of 36%. In our study the median survival rate was 6 months. When those sites assigned and those not assigned as primary were compared in terms of survival time the median period was found to be 6 months against 4 months (p=0.08). When the chemosensitive group including potential tumors of the ovary, testis and periton was compared with the other tumors the median survival rate was found to be 11 months against 6 months (p=0.036). When chemosensitive tumors were excluded from potential primary tumors the difference in median survival time was found to be 6 months among those with a potential primary site and 4 months among those whose potential primary site was unknown (p =0,12). Positive serokeratin 20 was found to be significantly lower in patients with potential lung cancer (p =0,002). According to results of univariate analysis survival rates are associated with alkaline phosphatase, hemoglobin, lactate dehidrogenase response to chemotherapy and liver metastasis. However in multivariate analysis survival rates were found to be only associated with liver metastasis and response to chemotherapy. It was found that the survival rate was not affected by those assigned and those not assigned as potential primary sites. Identification of the chemosensitive group will help in improving the rates of survival. Key words : Cancer of unknown primary, prognosis, chemotherapy, survival
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Primeri Bilinmeyen Kanser, Prognoz, Kemoterapİ, Sağkalım, Cancer of Unknown Primary, Prognosis, Chemotherapy, Survival
