Over kanserlerinde prognostik faktörler
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Over kanseri, jinekolojik kanserler içerisinde en ölümcül seyreden kanserdir. Çalışmamızın amacı over kanserli hastalarda prognostik faktörlerin değerlendirilmesidir. Çalışmamıza 01.01.2003-01.01.2017 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Kadın Hastalıkları Bölümü'nde over kanseri nedeni ile opere edilmiş 308 hasta dâhil edildi. Hasta dosyalarından, hastaların preoperatif, operatif ve postoperatif bilgileri geriye dönük olarak tarandı. Çalışmamıza alınan hastaların çoğunluğu Trakya Bölgesi'nde ikamet eden, postmenopozal veya "fazla kilolu/obez" olan hastalardı. Ortanca yaş 55 idi. Hastaların %93,2'si epitelyal kökenli over kanseri idi. Bu grubun %66,2'si seröz over kanseri, %12,5'i endometrioid kanser, %7,3'ü müsinöz kanser tanısı almıştı. Hastaların % 62'si Evre 3 veya Evre 4'tü. Beş yıllık "genel sağkalım" Evre 1 olgularda %89,4; Evre 3 olgularda %51,2 idi. Beş yıllık "hastalıksız sağkalım" oranları Evre 1 hastalarda %85,5, Evre 3 hastalarda %21 olarak görüldü. Evre 4 hastalarda iki yıllık "hastalıksız sağkalım" oranı %0'dı. Vakaların %68,5'i diğer kliniklere konsülte edilmeden bitirilmiş, diğer vakalar Genel Cerrahlara, Göğüs Cerrahlarına, Ürologlara veya Kalp-Damar Cerrahlarına danışılmıştı. Olguların %61,7'sinde preoperatif batın içi asit mevcuttu. Operasyonların %55,9'unda rezidü tümörün kalmadığı görüldü. Patolojik değerlendirmede hastaların %59,7'sinde malign sitoloji olduğu kaydedilmişti. Hastaların yarısından fazlasında peritoneal, omental tutulum veya lenfovasküler invazyon vardı. Peroperatif komplikasyon oranı %8,8 iken, postoperatif komplikasyon oranı %15,3 idi.
Ovarian cancer is the most fatal cancer amongst gynecological cancers. The aim of our study was to evaluate the prognostic factors in ovarian cancer patients. A total of 308 patients, who were operated due to ovarian cancer at the Department of Gynecology in Trakya University, Faculty of Medicine between 1st of January 2003and 1st of January 2017, were included in the study. Preoperative, operative and postoperative data of the patients were retrospectively evaluated from the patients' files. Most of the patients, included in the study, were living in the Trakya Region and were postmenopausal and overweight or obese. Median age was 55 in the whole group. Out of 308 women with ovarian cancer, 93,2% had epithelial ovarian cancer. In this group of women, 66,2% had serous, 12,5% had endometrioid and 7,3% had mucinous carcinoma. Sixty-two percent of the patients had Stage 3 or Stage 4 disease. The 5-year "overall survival" was 89,4% in Stage 1,whereas it was 51,2% in Stage 3 patients. The 5-year "disease free survival" was 85,5% in Stage 1 women,butit was 21% in Stage 3 patients. In women in Stage 4, 2-year "disease free survival" was zero. Perioperative consultation was not needed in 68.5% of the patients. Others were consulted perioperatively to general surgeons, thoracic surgeons, urologists or cardiovascular surgeons. Intraabdominal ascites was present in 61,7% of the patients. Residual tumor load was zero in 55,9% of the women after surgery. Perioperative malignant cytologywas detecteddue to pathological examination in 59,7% of the patients. Peritoneal or omental tumor implants, or lymphovascular invasionwas present in more than 50% of the patients. Perioperative complication rate was 8,8%, while postoperative complication was observed in 15,3% of the patients. Presence of hypertension, diabetesmellitus, asthma, hypothyroidism, gravidity or parity revealed a lack of association with overall survival. On the other hand, old age at the time of diagnosis, having postmenopausal status, having high platelet, CA-125, CA 15-3 or CEA levels, the presence of intraabdominal ascites, malignant cytology, residual tumor, lymph node metastasis, peritoneal or omental implants, lymphovascular invasion, need for blood transfusion or postoperative intensive care unit stay were all correlated with poor prognosis.
Ovarian cancer is the most fatal cancer amongst gynecological cancers. The aim of our study was to evaluate the prognostic factors in ovarian cancer patients. A total of 308 patients, who were operated due to ovarian cancer at the Department of Gynecology in Trakya University, Faculty of Medicine between 1st of January 2003and 1st of January 2017, were included in the study. Preoperative, operative and postoperative data of the patients were retrospectively evaluated from the patients' files. Most of the patients, included in the study, were living in the Trakya Region and were postmenopausal and overweight or obese. Median age was 55 in the whole group. Out of 308 women with ovarian cancer, 93,2% had epithelial ovarian cancer. In this group of women, 66,2% had serous, 12,5% had endometrioid and 7,3% had mucinous carcinoma. Sixty-two percent of the patients had Stage 3 or Stage 4 disease. The 5-year "overall survival" was 89,4% in Stage 1,whereas it was 51,2% in Stage 3 patients. The 5-year "disease free survival" was 85,5% in Stage 1 women,butit was 21% in Stage 3 patients. In women in Stage 4, 2-year "disease free survival" was zero. Perioperative consultation was not needed in 68.5% of the patients. Others were consulted perioperatively to general surgeons, thoracic surgeons, urologists or cardiovascular surgeons. Intraabdominal ascites was present in 61,7% of the patients. Residual tumor load was zero in 55,9% of the women after surgery. Perioperative malignant cytologywas detecteddue to pathological examination in 59,7% of the patients. Peritoneal or omental tumor implants, or lymphovascular invasionwas present in more than 50% of the patients. Perioperative complication rate was 8,8%, while postoperative complication was observed in 15,3% of the patients. Presence of hypertension, diabetesmellitus, asthma, hypothyroidism, gravidity or parity revealed a lack of association with overall survival. On the other hand, old age at the time of diagnosis, having postmenopausal status, having high platelet, CA-125, CA 15-3 or CEA levels, the presence of intraabdominal ascites, malignant cytology, residual tumor, lymph node metastasis, peritoneal or omental implants, lymphovascular invasion, need for blood transfusion or postoperative intensive care unit stay were all correlated with poor prognosis.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
