Tip III radikal histerektomiyle tedavi edilmiş serviks Ib karsinomunda parametriyal invazyon, lenf nodu metastazı ve cerrahi sınır pozitifliği gibi yüksek risk faktörlerinin prognostik önemi

Taner Turan; Abdullah Boztosun; Nurettin Boran; Nuray Yüksel; Gökhan Tulunay; Yetkin Karasu; Fatma Önalan; Faruk Köse; Ali Haberal

EN TR

Effect of high rist factors including lymph node metastasis, parametrial invasion, positive surgical margin on prognosis of patients treated with type III radical hysterectomy for cervical cancer stage Ib

Abstract

Aim. In this study we analyze the effect of risk factors (lymph node metastasis, parametrial invasion, positive surgical margin) determining high risk group on prognosis after radical hysterectomy. Method. Files of the patients with cervical cancer stage IB those were treated with type III radical hysterectomy +/- bilateral salpingoopherectomy+ systemic bilateral pelvicparaaortic lymphadenectomy in our clinics between 1993-2007 investigated retrospectively. We included 119 patients who were not treated with neoadjuvant chemotherapy, who had sufficent data of pathology, who had at least 5 year follow up or who had recurrent disease or die in five years. Results. Median age of the patients was 53,8 (34-80) and mean tumor size was 30 mm (5- 65). According to the postoperative pathology reports, 54 patients (45,4%) had one or more parameters of high risk group. There were 40 patients with one, 10 patients with two, 4 patients with three risk factors. In whole group 5 year disease free life was 78.2%, survival rate was 80.7%. There was a significant negative effect of presence of risk factors on survival rates. In patients with no high risk factor, 5 year disease free life rate was 87.7% and 5 year survival rate was 90.8%. In the presence of one or more of these factors these ratios decrease to 66.7% and 68.5% reciprocally. Number of positive risk factors of patients was not significant. Conclusion. In this study it is shown that current high risk definition is valid and usefull.

Keywords

Tip III radikal histerektomiyle tedavi edilmiş serviks Ib karsinomunda parametriyal invazyon, lenf nodu metastazı ve cerrahi sınır pozitifliği gibi yüksek risk faktörlerinin prognostik önemi

Öz

Bu çalışmada radikal histerektomi sonrası yüksek-risk grubunu belirleyen faktörlerin (lenf nodu metastazı, parametriyal invazyon, cerrahi sınır pozitifliği) prognoz üzerindeki etkisi değerlendirildi. Yöntem. Kliniğimizde 1993-2007 yılları arasında evre IB serviks kanseri tanısı alıp tip III radikal histerektomi +/- bilateral salpingo-ooforektomi + sistematik bilateral pelvik-paraaortik lenfadenektomi yapılan hastaların dosyaları tarandı. Neoadjuvant kemoterapi almayan, patoloji kaydı yeterli olan ve en az 5 yıllık takibi olan veya 5 yıl içinde nüks gelişen veya ölen 119 hastanın verileri gözden geçirildi. Bulgular. Hastaların ortalama yaşı 53,8 (34-80) ve ortanca tümör boyutu 30 mm idi (5-65). Operasyon sonrası patoloji sonucuna göre yüksek risk grubundan herhangi bir parametreyi taşıyan hastaların sayısı 54'tü (%45,4). Bunlardan 40 olgunun sadece bir, 10 olgunun iki ve dört olgunun üç yüksek risk faktörü taşıdığı belirlendi. Tüm grupta 5 yıllık hastalıksız yaşam oranı %78,2, sağ kalım oranı %80,7 idi. Risk faktörlerinin varlığı yaşam oranlarını belirgin olarak kötüleştirmekteydi. Bu faktörlerden hiç birinin olmadığı hastalarda 5 yıllık hastalıksız yaşam oranı %87,7, 5 yıllık sağ kalım oranı %90,8'di. Ancak risk faktörlerinden her hangi birinin varlığı durumunda bu oranlar sırasıyla %66,7'ye ve %68,5'e düşmekteydi. Hastadaki pozitif risk faktörü sayısının önemli olmadığı görüldü. Sonuç. Bu çalışmada, günümüzde kabul edilen yüksek-risk tanımlamasının doğru bir tanımlama olduğu görüldü.

Anahtar Kelimeler

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Taner Turan

Abdullah Boztosun

Nurettin Boran

Nuray Yüksel

Gökhan Tulunay

Yetkin Karasu

Fatma Önalan

Faruk Köse

Ali Haberal

Yayımlanma Tarihi

25 Haziran 2009

Gönderilme Tarihi

25 Haziran 2009

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2009 Cilt: 31 Sayı: 3

IZ

https://izlik.org/JA93RD89KF

Kaynak Göster

RIS / Bibtex

AMA

1.Turan T, Boztosun A, Boran N, vd. Tip III radikal histerektomiyle tedavi edilmiş serviks Ib karsinomunda parametriyal invazyon, lenf nodu metastazı ve cerrahi sınır pozitifliği gibi yüksek risk faktörlerinin prognostik önemi. CMJ. 2009;31(3):272-278. https://izlik.org/JA93RD89KF