Mustafa KOCAER, Kemal GÜNGÖRDÜK, Muzaffer SANCI, Varol GÜLSEREN, Mehmet GÖKÇÜ, İsa Aykut ÖZDEMİR

Servikal Kanser Olgularına Uygulanan Tedavilerin Karşılaştırılması; Tek Merkezli Retrospektif Çalışma

Amaç: Retrospektif ve tek merkezli olarak servikal kanserli olgulara erken evre ve lokal ileri evrelerde uygulanan tedavi tiplerinin sağkalım ve nüks sonuçlarını karşılaştırmakdır.Gereç ve Yöntemler: Tepecik Eğitim Araştırma Hastanesi Jinekoloji Onkoloji Kliniğinde 1992– 2015 tarihleri arasında serviks kanseri tanısını alan ve tedavi uygulanan 844 hastanın kayıtları retrospektif olarak incelendi. Uygulanan tedavi şekillerine göre erken evre evre IA-IB1 ve lokal ileri evre LİE IB2-IVA gruplarına ayrıldı. Sağkalım analizleri Kaplan-Meier metodu ile yapıldı ve sonuçlar log-rank testi ile karşılaştırıldı.Bulgular: Erken evre serviks kanseri hastalarında histerektomi yapılan 88, primer radyoterapi verilen 16, histerektomi sonrası adjuvan radyoterapi verilen 103 ve histerektomi sonrası adjuvan kemoradyoterapi verilen 65 hasta 4 farklı tedavi grubunu oluşturdu. Erken evre serviks kanseri hastalarına verilen tedavi modalitelerine göre 5 yıllık hastalıksız sağkalım sonuçlarında farklılık olmadığı ancak toplam sağkalım süresinin primer radyoterapi grubunda düşük olduğu ve nüks oranlarının yüksek olduğu görüldü.LİE hastalarda primer radyoterapi verilen 97 hasta, primer kemoradyoterapi verilen 313 hasta, histerektomi sonrası adjuvan radyoterapi verilen 50 hasta, histerektomi sonrası adjuvan kemoradyoterapi verilen 82 hasta olduğu görüldü. LİE serviks kanseri hastalarına verilen tedavi modalitelerine göre 5 yıllık hastalıksız sağkalım ve toplam sağkalım oranlarının primer radyoterapi alan hastalarda daha düşük ve nüks oranlarının primer radyoterapi grubunda daha yüksek olduğu görüldü.Sonuç: Hem erken evre hem de LİE serviks kanserinde uygulanan tedavi grupları arasında, primer radyoterapi tedavisinin diğer gruplardan istatistiksel olarak anlamlı olarak toplam sağkalım süresinin kısa ve nüks görülme oranlarının fazla olduğu gösterildi

Anahtar Kelimeler:

Serviks kanseri, Radyoterapi, Radikal histerektomi

Comparison of Treatments for Cervical Cancer Cases; Single Center Retrospective Study

Objective: To compare the survival and recurrence outcomes of treatment methods which have been applied to cervical cancer cases early and local advanced stages in a retrospective and single center setting.Material and Methods: The records of 844 patients who were diagnosed with cervical cancer and were treated between 1992 and 2015 at the Gynecologic Oncology Clinic of Tepecik Education Research Hospital were retrospectively evaluated. Patients were divided into early stage stage IAIB1 and local advanced stage LIE IB2-IVA groups according to the treatment regimens. Survival analyses were performed by the Kaplan-Meier method and the results were compared with the logrank test.Results: Early stage cervical cancer patients constituted 4 different treatment groups: 88 patients underwent hysterectomy, 16 patients received primary radiotherapy, 103 received adjuvant radiotherapy after hysterectomy and 65 patients received adjuvant chemoradiotherapy after hysterectomy. There was no difference regarding the 5-year disease-free survival outcomes according to treatment modalities for early stage cervical cancer patients, but the overall survival time was lower in the primary radiotherapy group and the recurrence rates were higher.There were 97 patients who received primary radiotherapy, 313 patients who received primary chemoradiotherapy, 50 patients who received adjuvant radiotherapy after hysterectomy, and 82 patients who received adjuvant chemoradiotherapy after hysterectomy in the LIE group. According to the treatment modalities for LIE cervical cancer patients, 5-year disease-free survival and total survival rates were lower in patients receiving primary radiotherapy and recurrence rates were higher in primary radiotherapy group.Conclusion: Among the treatment modalities applied in both early stage and LIE cervical cancer patients, it was statistically significant that the duration of total survival was shorter and recurrence rates were higher in the treatment of primary radiotherapy than the other treatment groups

Keywords:

Cervical cancer, Radiotherapy, Radical hysterectomy,

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