REKÜRREN KOLOREKTAL KANSERLİ HASTALARDA PRİMER TÜMÖR LOKALİZASYONU VE SAĞKALIM ARASINDAKİ İLİŞKİ

Amaç: Yakın zamanda metastatik kolon kanseri üzerinde yapılan çalışmaların geriye dönük verilerine da-yanarak, primer tümör lokalizasyonunun sağ kalımı ve kemoterapi (KT) yanıtını etkileyen bir faktör olduğugörülmüştür. Bu çalışmaların çoğunda metastatik halde tanı alan hastalar dahil edilmiştir. Çalışmamızda tanıanında erken evrede olan, cerrahi ve veya adjuvan tedaviler sonrası nükseden hastalarda primer tümörünlokalizasyonunun önemi olup olmadığı incelendi.Hastalar ve Metod: Tıbbi Onkoloji kliniğince 2013 ile 2017 yılları arasında kolorektal kanser tanısıyla takipedilmiş, tanı anında Evre II ve Evre III olup sonrasında metastaz gelişen 79 hasta çalışmaya dahil edildi. Has-talar primer tümörün lokalizasyonuna göre, sağ ve sol olarak iki gruba ayırıldı. Hastaların demografik verilerisağkalım süreleri primer tümör lokalizasyonuna göre karşılaştırıldı.Bulgular: Toplam 79 hastanın ortalama yaşları sağ ve sol grupta sırasıyla 60 ve 59 yıl olarak benzerken (P =0.965), demografik verilere bakıldığında iki grup arasında sağ kolonda Tip2 diabetes mellitus (Tip2DM) gö-rülme oranının yüksekliği (sırasıyla %34.5 ve %4.4, P = 0.002) haricinde anlamlı fark saptanmadı. NeoadjuvanKT sol gurupta ve nodal tutulum varlığı ise sağ tarafta yüksek saptansa da fark istatistiksel olarak anlamlıdeğildi. Yine her iki gurup arasında adjuvan KT almış olma, adjuvan KT ve palyatif KT rejimleri arasında farksaptanmadı. Sağkalım analizinde, sağ ve sol guruplar arasında progresyonsuz sağkalım (PS) ve toplam sağ-kalım (TS) oranları benzerdi [PS sırasıyla 11.9 (6-17.9) ay’a karşı 16.7 (13.1-20.4) ay, P = 0.976 ve TS sırasıyla36.1 (14.6-57) ay’a karşı 40.8 (35.3-46) ay, P = 0.636].Sonuç: Çalışmamızda tanı anında metastatik olmayan bu hasta gurubunda, primer tümör lokalizasyonununsağ kalım üzerine etkili bir faktör olmadığı saptandı. Bu durum, cerrahi, neoadjuvan ve adjuvant tedavilerinetkinliklerinin, primer tümör lokalizasyonunun önemini gölgelediğini düşündürmektedir.

The relationship Between Primary Tumor Localization and Survival in Patients with Recurrent Colorectal Cancer.

Objective: Based on retrospective data from previous studies on metastatic colon cancer, it has recently been found that primary tumor localization is a factor affecting survival and response to chemotherapy (CT). Most of these studies included de-novo metastatic patients. In this study, investigation indicated that whet- her primary tumor localization was helpful in patients relapsed after surgical and-or adjuvant treatment rather than metastatic at the time of diagnosis. Patients and Methods: A total of 79 patients with stage II and stage III metastatic colorectal cancer disease whom diagnosed in the Department of Medical Oncology, between 2013 and 2017, were included in the study. Patients were divided into two groups according to localization of the primary tumor as right and left. Demographic data of the patients were compared with survival time according to primary tumor localization. Findings: The mean ages of 79 patients were similar in the right and left groups (59 vs 60 years, P = 0.965). According to demographic features, there were no significant differences was found between the two groups except for the high incidence of Type2 diabetes mellitus (T2DM) in right-sided (34.5% and 4.4%, P = 0.002, respectively). Neoadjuvant CT in the left group and nodal involvement in the right side were higher, however not statistically significant. Again, there was no difference between the two groups in terms of receiving adjuvant CT, regimens of adjuvant CT and palliative CT. Survival analysis showed that the PS and TS ratios were similar between the right and left groups [PS was 11.9 (6-17.9) months versus 16.7 (13.1-20.4) months, P = 0.976 and TS, respectively, 36.1 (14.6-57) months 40.8 (35.3-46) months, P = 0.636]. Conclusion: According to results of our study, it was determined that primary tumor localization was not an important factor on survival in patients with early colorectal cancer. This suggests that the efficacy of surgery, neoadjuvant, and adjuvant treatments may be more important than primary tumor localization.

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