Hatime Arzu YAŞAR, Mehmet Berk ÖRÜNCÜ, Güngör UTKAN, Hakan AKBULUT

Lokal ileri rektum kanserinde sağkalımı etkileyen faktörler - Tek merkez deneyimi

Giriş ve Amaç: Rektum kanserinin prognozunu predikte edebilmek; hasta yönetiminde uygun tedaviyi uygulayabilmek, gereksiz tedavilerden kaçınabilmek ve medikal kaynakları uygun kullanabilmek için önemlidir. Bu çalışmada neoadjuvan kemoradyoterapi uygulanan lokal ileri rektum kanseri tanısı olan hastalarda sağkalım ile ilişkili faktörleri araştırdık. Gereç ve Yöntem: 2014-2018 yılları arasında Ankara Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı’na başvuran lokal ileri rektum kanseri tanısı olan 78 hastanın klinik, patolojik, laboratuvar verileri hastane kayıtlarından retrospektif olarak tarandı. Sağkalım üzerine etkili faktörler log-rank testi ile değerlendirildi. Sağkalım analizleri Kaplan-Meier metodu ile yapıldı. Bulgular: Çalışmaya dahil edilen 78 hastanın ortanca yaşı 61 idi. Hastaların %34.6’sı (n: 27) kadın, %65.4’ü (n: 51) erkek idi. Ortanca sağkalım süresi 62 ay olarak saptandı. Postoperatif N2 lenf nodu pozitifliği ve postoperatif tümör derecesi 3 olan, radyoterapinin tamamlanamadığı, adjuvan tedavi almayan ve ileri yaşta olan hastalarda istatistiksel anlamlı olarak toplam sağkalım daha kötü saptandı (p < 0.05). Sonuç: Neoadjuvan kemoradyoterapinin standart tedavi haline geldiği fakat radyoterapi uygulamasının uzun süreli radyoterapi ya da kısa süreli radyoterapi olarak değişiklik gösterebildiği bu süreçte yaş, radyoterapinin tamamlanması, postoperatif N2 nod pozitifliği, postoperatif tümör derecesi ve adjuvan tedavi sağkalımı etkileyen faktörler olarak tanımlandı.

Anahtar Kelimeler:

Rektum kanseri, sağkalımı etkileyen faktörler, neoadjuvan tedavi, adjuvan tedavi

Factors affecting survival in locally advanced rectal cancer - Single center experience

Backlground and Aims: Predicting the prognosis of rectal cancer is important in patient management to be able to apply appropriate treatment, to avoid overtreatment and to use medical resources appropriately. In this study, our aim is to investigate the factors associated with survival in patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy. Materials and Methods: Clinical, pathological, and laboratory data of 78 patients with locally advanced rectal cancer who applied to Ankara University Faculty of Medicine, Department of Medical Oncology between 2014 and 2018 were retrospectively scanned from hospital records. Factors that may be associated with survival were evaluated with the log-rank test. Survival analyses were performed using the Kaplan-Meier method. Results: The median age of 78 patients included in the study was 61. 34.6% (n: 27) of the patients were female and 65.4% (n: 51) were male. The median survival time was 62 months. Elderly patients, patients in whom radiotherapy could not be completed, patients with postoperative N2 lymph node positivity and postoperative tumor grade 3, and patients who did not receive adjuvant therapy had significantly worse overall survival (p < 0.05). Conclusion: Age, completion of radiotherapy, postoperative N2 node positivity, postoperative tumor grade, and adjuvant therapy were defined as factors affecting survival in a period like which neoadjuvant chemoradiotherapy became the standard treatment, but radiotherapy could vary as long-term radiotherapy or short-term radiotherapy

Keywords:

Rectal cancer, factors affecting survival, neoadjuvant therapy, adjuvant therapy,

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