Erken evre endometrium kanseri tanılı hastaların tedavi sonuçları: tek merkez deneyimi

kanser hastalarının klinikopatolojik özelliklerini ve tedavi sonuçlarını değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışma hastane bazlı retrospektif gözlemsel bir vaka serileri çalışmasıdır. 2009-2015 yılları arasında Başkent Üniversitesi Tıbbi Onkoloji ve Jinekolojik Onkoloji Anabilim Dallarına başvuran 116 hasta dahil edildi. De-novo metastatik hastalar çalışmaya dahil edilmedi.Bulgular: Hastaların medyan yaşı 58 (dağılım 27-81) idi. Hastaların hepsinin ECOG performans puanı 0 (n: 116) idi. Endometrioid histoloji en sık görülen histopatolojik alt tipti (n: 103,% 88). Tüm hastalar lokal ve lokal ileri evrede idi. Hastaların önemli oranda bir kısmının grade 2 tümörü vardı (n: 55,% 47.4). Myometrial invazyon 78 hastada (% 67.2)% 50'den azdı. Ortanca takip süresi 61 ay idi ve 8 (% 6.9) hasta öldü. Tüm hastalara standart lenfadenektomi ile standart cerrahi evreleme yapıldı. Median genel sağkalım süresine (OS) ulaşılamadı. Sırasıyla 14 hasta (% 12.1) ve 34 hasta (% 29.3) adjuvan kemoterapi ve radyoterapi ile tedavi edildi.Sonuç: Endometrial kanser kadınlarda en sık görülen jinekolojik tümörler olmasına rağmen, tedavi oranı çok yüksektir. Nüks oranı % 6 (7 hasta) idi ve nüksün çoğu lokal,% 71.4 (5 hasta) idi.

Anahtar Kelimeler:

Endometrium kanseri, bazal klinikopatolojik özellikler, tedavi sonuçları

Treatment outcomes of early stage endometrial cancer patients: single center experience

Purpose:Endometrium cancers are the most common gynecological cancer type in women. Surgery is the standard treatment for women with early stage endometrial cancer patients. The adjuvant treatment of early stage endometrial cancer is based on the risk and expected type (local vs systemic) of relapse. In this study, we evaluated clinicopathological characteristics and treatment outcomes of endometrial cancer patients in our center.Materials and Methods:This study was a hospital-based retrospective observational case-series study. 116 patients were included in the study from Baskent University Department of Medical Oncology and Gynecological Oncology between the years of 2009-2015. De-novo metastatic patients were not included in the study. Results:The median age of the patients was 58 (range 27-81) years. All of patients had European Cooperative Oncology Group (ECOG) performance score 0 (n:116). Endometrioid histology was the most common histopathological subtype (n:103, 88%). All of the patients were in local and local advanced stage. The significant percentage of patients had grade 2 tumor (n:55, 47.4%). Myometrial invasion was less than 50% in 78 patients (67.2 %). The median follow-up time was 61 months and 8 (6.9%) patients died. All patients underwent standard surgical staging with standard lymphadenectomy. Overall survival (OS) was not reached. There were 14 patients (12.1 %) and 34 patients (29.3 %) treated with adjuvant chemotherapy and radiotherapy, respectively.Conclusion:Though endometrial cancer is the most common gynecological tumors in women, cure rate is very high. Relapse rate was 6 % (7 patients) and most of the relapse were local, 71.4% (5 patients).

Keywords:

Endometrium cancer, basal clinicopathological characteristics, treatment outcomes,

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1. American College of Obstetricians and Gynecologists. ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer. Obstet Gynecol 2005;106:413-25.
2. Kimura T, Kamiura S, Yamamoto T, Seino-Noda H, Ohira H, Saji F. Abnormal uterine bleeding and prognosis of endometrial cancer. Int J Gynaecol Obstet 2004;85:145-50.
3. Seebacher V, Schmid M, Polterauer S, HeflerFrischmuth K, Leipold H, Concin N et al. The presence of postmenopausal bleeding as prognostic parameter in patients with endometrial cancer: a retrospective multi-center study. BMC Cancer. 2009;9:460.
4. Rahatli S, Dizdar O, Kucukoztas N, Oguz A, Yalcin S, Ozen O et al. Good outcomes of patients with stage IB endometrial cancer with surgery alone. Asian Pac J Cancer Prev. 2014;15:3891-3.
5. Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92:744-51.
6. Soslow RA, Tornos C, Park KJ, Malpica A, MatiasGuiu X, Oliva E et al. Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists. Int J Gynecol Pathol. 2019;38:S64-74.
7. Morrow CP, Bundy BN, Kurman RJ, Creasman WT, Heller P, Homesley HD et al. Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol. 1991;40:55-65.
8. Eifel PJ, Ross J, Hendrickson M, Cox RS, Kempson R, Martinez A. Adenocarcinoma of the endometrium. Analysis of 256 cases with disease limited to the uterine corpus: treatment comparisons. Cancer. 1983;52:1026-31.
9. Straughn JM Jr, Huh WK, Kelly FJ, Leath CA 3rd, Kleinberg MJ, Hyde J Jr et al. Conservative management of stage I endometrial carcinoma after surgical staging. Gynecol Oncol. 2002;84:194-200.
10. Sarı ME, Meydanlı MM, Yalçın I, Şahin H, Çoban G, Çelik H et al. Risk factors for lymph node metastasis among lymphovascular space invasion-positive women with endometrioid endometrial cancer clinically confined to the uterus. Oncol Res Treat. 2018;41:750-4.
11. Wang HL, Ren YF, Yang J, Qin RY, Zhai KH. Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis. Asian Pac J Cancer Prev. 2013;14:2515-9.
12. Güngördük K, Firat Cüylan Z, Kahramanoglu I, Oge T, Akbayir O, Dede M et al. Risk factors for recurrence in low-risk endometrial cancer: a casecontrol study. Oncol Res Treat. 2018;41:466-70.