Abstract
Aim: To retrospectively examine ovarian cancers in our clinic.
Material and Methods: 350 patients who were operated on with the preliminary diagnosis of pelvic mass. 100 patients with cancer were detected as a result of pathology. 6 patients could not be obtained, 94 patients were included in the study. The effects of BMI, preoperative CA-125 value, histopathological diagnosis of the tumor, stage of the disease, and removed LND on survival were examined.
Results: The average age is 48.18±13.84 years, the average BMI is 27.19±5.46 kg/m2, the average operation time is 219.26±98.88 minutes, the average number of LND removed is 43, the follow-up period of the patients is 12. - 96 months. In the histopathological distribution of the patients, epithelial ovarian cancer was observed in the first place with 51 cases (54.1%). The pathological stage, stage IA, was detected in 35 (37.2) of the patients and took the first place.Optimal cytoreductive surgery was performed in 92 (97.8%) patients and suboptimal cytoreductive surgery was performed in 2 (2.2%) patients. 46 patients received chemotherapy (CT). 7 of 46 patients (15.2%) received neoadjuvant+adjuvant chemotherapy and 39 (84.7%) received adjuvant chemotherapy. The survival rate is 62%. The survival rate is 62%. LND numbers and BMI is’nt difference was observed (p>0.05).
Conclusion: Abnormal CA-125 value, detection of the disease at an early stage, borderline tumor type and having the patient operated on by an experienced surgeon are associated with a good prognosis.
Keywords
References
- Sung H, Siegel RL,Küresel Kanser İstatistikleri 2020:GLOBOCAN 185 Ülkede 36 kanser için Dünya Çapında İnsidans ve Ölüm Tahminleri.CA Kanser j Clin 2021;71:209
- Siegel RL,Miller KD,Wagle NS,Jemal A,Kanser İstatistikleri,2023.CA Kanser j Clin 2023 ;73:17.
- Kanser İstatistikleri Gerçekleri: Yumurtalık Kanseri. Cancer.gov. Şu adreste mevcuttur: https://seer.cancer.gov/statfacts/html/ovary.html (24 Eylül 2019’da erişildi).
- Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JW, et al. Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol 2007;8:773-83.
- Quaye L, Gayther SA, Ramus SJ, Di Cioccio RA, McGuire V, Hogdall E, et al. The effects of common genetic variants in oncogenes on ovarian cancer survival. Clin Cancer Res 2008;14:5833-9.
- Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era; a meta-analysis. J Clin Oncol 2002 ; 20 : 1248 – 59.
- Tuxen MK, Soletormos G, Dombernowsky P. Tumor markers in the management of patients with ovarian cancer.Cancer Treat Rev 1995;21:215-45.
- Gadducci A, Cosio S, Carpi A ve ark. Serum Tumor markers in the management of ovarian, endometrial and cervical cancer Biomedecine & Pharmacotherapy 2004:58;24-38
- Int J Gynecol Cancer. 2005 Nov-Dec;15 (6):1014-22.
- National cancer İnstitute:Overian Epitelial cancer treatment Available at:health professionel.Accessed May 12,2011
- Burghardt E, Girardi F, Lahousen M, Tamussino K, Stettner H. Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol 1991 ; 40 : 103 – 6.
- Onda T, Yoshikawa H, Yokota H, et al. Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma: a proposal
- Morice P, Joulie F, Rey A, Atallah D, Camatte S, Pautier P, et al. Are nodal metastases in ovarian cancer chemoresistant lesions? Analysis of nodal involvement in 105 patients treated with preoperative chemotherapy. Eur J Gynaecol Oncol 2004 ; 25 : 169 – 74.
- Burghardt E, Winter R. The effect of chemotherapy on lymph node metastases in ovarian cancer. Baillieres Clin Obstet Gynaecol 1989 ; 3 : 167 – 71.
- Scarabelli C, Gallo A, Visentin MC, et al. Systematic pelvic and para-aortic lymphadenectomy in advanced ovarian cancer patients with no residual intraperitoneal disease. Int J Gynecol Cancer 1997; 7: 18–26
- Spirtos NM, Gross GM, Freddo JL, Ballon SC. Cytoreductive surgery in advanced epithelial cancer of the ovary: the impact of aortic and pelvic lymphadenectomy. Gynecol Oncol 1995 ; 56 : 345 – 52.
- Benedetti Panici P, Landoni F, Scarabelli C, et al. Systematic aortic and pelvic lymphadenectomy (SAPL) vs resection of any bulky nodes (RBN) only for optimally debulked advanced ovarian cancer (AOC): preliminary report from an international randomized trial [abstract 132]. Int J Gynecol Cancer 1999; 9 (Suppl 1): 44
- Chabner BA, Lynch TJ, Longo DL. Ovarian Cancer. Harrison’s Manual of Oncology. The McGraw-Hill Companies 2008. pp.485-502.
- Chan JK, Tian C, Kesterson JP, Monk BJ, Kapp DS, Davidson B, Robertson S, Copeland LJ, Walker JL, Wenham RM, Casablanca Y, Spirtos NM, Tewari KS, Bell JG. Symptoms of Women With High- Risk Early-Stage Ovarian Cancer. Obstet Gynecol. 2022 Feb 1;139 (2):157-162. doi: 10.1097/AOG.0000000000004642. PMID: 34991145; PMCID: PMC9126568.
- Yawn BP, Barrette BA, Wollan PC. Yumurtalık kanseri: ihmal edilen tanı. Mayo Clin Proc. 2004 Ekim;79 (10):1277-82. doi: 10.4065/79.10.1277. PMID: 15473410.
Abstract
Amaç: Kliniğimizde yumurtalık kanserlerini retrospektif olarak inceleyerek sağ kalım üzerine etkileri tartışılan BMI, preoperatif CA-125 değeri, evre, histopatolojik tanı, çıkarılan lenf nodu disseksiyon sayısı (LND) ve sitoredüktif cerrahiyi analiz etmektir.
Gereç ve Yöntem: Ocak 2007-Haziran 2015 yılları arasında Ümraniye Eğitim ve Araştırma Hastanesinde pelvik kitle ön tanısıyla opere edilen 350 hasta retrospektif incelendi. 350 hastadan patoloji sonucu kanser gelen 100 hasta tespit edildi. 6 hastanın sağkalım bilgilerine ulaşılamadığından çalışmadan çıkarıldı. Çalışmaya 94 hasta dahil edildi. Hastaların yaşı, body mass index (BMI)’i,kronik hastalık ve geçirilmiş operasyon varlığı,preoperatif CA-125 değeri,operasyon süresi,tümörün histopatolojik tanısı,çıkarılan LND sayısı, hastalığın evresi,yapılan optimal sitoredüktif cerrahi sayısı,hastalara uygulanan neoadjuvan ve adjuvan kemoterapi,hastalığın sağkalımı ve bu parametrelerden BMI’nın,preop CA-125 değerinin,tümörün histopatolojik tanısının, hastalığın evresinin, çıkarılan LND’nin sağ kalım üzerine etkisi incelendi.
Bulgular: Olguların yaş ortalaması 48,18±13,84 yıl , ortalama BMI’ sı 27,19±5,46 kg/m2 ortalama operasyon süresi 219,26±98,88 dakika, çıkarılan ortalama LND sayısı 43,hastaların takip süresi 12 - 96 ay arasındadır.Hastaların histopatolojik dağılımlarını 51 olgu (%54,1) ile epitelyal over kanseri ilk sırada izlendi.Cerrahi evreleme sonrasında hastaların 35’inde (37.2) patolojik evre, evre IA tespit edilmiş olup ilk sırayı aldı. 92 (%97,8) hastaya optimal, 2 (%2,2) hastaya suboptimal sitoredüktif cerrahi uygulandı. 46 hasta kemoterapi (KT) aldı. 46 hastanın 7’si (%15,2) neoadjuvan+adjuvan kemoterapi 39’u (%84,7) adjuvan KT aldı. Ortalama sağkalım süresi 35.62±21.94 aydır. Son ölüm 77. ayda görülmüş olup; sağkalım oranı %62 dir.LNDD ve BMI’ nın sağ kalım üzerine etkisi incelendiğinde farklılık izlenmemiştir (p>0,05).
Sonuç: CA-125 değerinin normal olması, hastalığın erken evrede tespiti,tümör tipinin borderline olması ve hastanın deneyimli bir cerrah tarafından opere edilmesi iyi prognoz ile ilişkilidir.
Keywords
References
- Sung H, Siegel RL,Küresel Kanser İstatistikleri 2020:GLOBOCAN 185 Ülkede 36 kanser için Dünya Çapında İnsidans ve Ölüm Tahminleri.CA Kanser j Clin 2021;71:209
- Siegel RL,Miller KD,Wagle NS,Jemal A,Kanser İstatistikleri,2023.CA Kanser j Clin 2023 ;73:17.
- Kanser İstatistikleri Gerçekleri: Yumurtalık Kanseri. Cancer.gov. Şu adreste mevcuttur: https://seer.cancer.gov/statfacts/html/ovary.html (24 Eylül 2019’da erişildi).
- Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JW, et al. Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol 2007;8:773-83.
- Quaye L, Gayther SA, Ramus SJ, Di Cioccio RA, McGuire V, Hogdall E, et al. The effects of common genetic variants in oncogenes on ovarian cancer survival. Clin Cancer Res 2008;14:5833-9.
- Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era; a meta-analysis. J Clin Oncol 2002 ; 20 : 1248 – 59.
- Tuxen MK, Soletormos G, Dombernowsky P. Tumor markers in the management of patients with ovarian cancer.Cancer Treat Rev 1995;21:215-45.
- Gadducci A, Cosio S, Carpi A ve ark. Serum Tumor markers in the management of ovarian, endometrial and cervical cancer Biomedecine & Pharmacotherapy 2004:58;24-38
- Int J Gynecol Cancer. 2005 Nov-Dec;15 (6):1014-22.
- National cancer İnstitute:Overian Epitelial cancer treatment Available at:health professionel.Accessed May 12,2011
- Burghardt E, Girardi F, Lahousen M, Tamussino K, Stettner H. Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol 1991 ; 40 : 103 – 6.
- Onda T, Yoshikawa H, Yokota H, et al. Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma: a proposal
- Morice P, Joulie F, Rey A, Atallah D, Camatte S, Pautier P, et al. Are nodal metastases in ovarian cancer chemoresistant lesions? Analysis of nodal involvement in 105 patients treated with preoperative chemotherapy. Eur J Gynaecol Oncol 2004 ; 25 : 169 – 74.
- Burghardt E, Winter R. The effect of chemotherapy on lymph node metastases in ovarian cancer. Baillieres Clin Obstet Gynaecol 1989 ; 3 : 167 – 71.
- Scarabelli C, Gallo A, Visentin MC, et al. Systematic pelvic and para-aortic lymphadenectomy in advanced ovarian cancer patients with no residual intraperitoneal disease. Int J Gynecol Cancer 1997; 7: 18–26
- Spirtos NM, Gross GM, Freddo JL, Ballon SC. Cytoreductive surgery in advanced epithelial cancer of the ovary: the impact of aortic and pelvic lymphadenectomy. Gynecol Oncol 1995 ; 56 : 345 – 52.
- Benedetti Panici P, Landoni F, Scarabelli C, et al. Systematic aortic and pelvic lymphadenectomy (SAPL) vs resection of any bulky nodes (RBN) only for optimally debulked advanced ovarian cancer (AOC): preliminary report from an international randomized trial [abstract 132]. Int J Gynecol Cancer 1999; 9 (Suppl 1): 44
- Chabner BA, Lynch TJ, Longo DL. Ovarian Cancer. Harrison’s Manual of Oncology. The McGraw-Hill Companies 2008. pp.485-502.
- Chan JK, Tian C, Kesterson JP, Monk BJ, Kapp DS, Davidson B, Robertson S, Copeland LJ, Walker JL, Wenham RM, Casablanca Y, Spirtos NM, Tewari KS, Bell JG. Symptoms of Women With High- Risk Early-Stage Ovarian Cancer. Obstet Gynecol. 2022 Feb 1;139 (2):157-162. doi: 10.1097/AOG.0000000000004642. PMID: 34991145; PMCID: PMC9126568.
- Yawn BP, Barrette BA, Wollan PC. Yumurtalık kanseri: ihmal edilen tanı. Mayo Clin Proc. 2004 Ekim;79 (10):1277-82. doi: 10.4065/79.10.1277. PMID: 15473410.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Gynecologic Oncology Surgery |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | April 30, 2024 |
| Publication Date | April 30, 2024 |
| Submission Date | December 25, 2023 |
| Acceptance Date | April 29, 2024 |
| Published in Issue | Year 2024 Volume: 24 Issue: 1 |
