UMUT VAROL, Nagihan AKKAŞ, Utku OFLAZOĞLU, Tarık SALMAN, Halil TAŞKAYNATAN, Seray SARAY, Yaşar YILDIZ, Ahmet ALACACIOĞLU, Yüksel KÜÇÜKZEYBEK, Mustafa Oktay TARHAN

Opere Over Kanseri Hastalarında Preoperatif Yüksek CA125 Değerinin Postoperatif Normal Sınırlara Dönmesinin Klinik Önemi

Amaç: CA125, over kanseri hastalarında gerek tanı aşamasında gerekse tedavi sonrası takiplerde tümör belirteci olarak kullanılmaktadır. Biz de çalışmamızda preoperatif serum CA125 değeri yüksek olan over kanseri hastalarında operasyondan sonraki değerlerinin normale dönüp dönmemesinin nüks riskini belirleme ve nükse kadar geçen süre açısından önemini araştırdık. Yöntem: Çalışmamızda 2005 – 2013 yılları arasında İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji Kliniğinde opere over kanseri tanısıyla takip ve tedavi edilen hastalar retrospektif olarak taranmıştır. CA125 sınır değeri olarak hem 35 IU/ml hem de 65 IU/ml kullanılarak iki farklı analiz yapılmıştır. Bulgular: Çalışmamıza bazal CA125 değeri yüksek olan (sınır değer >35 IU/ml ve 65 IU/ml alındığında) sırasıyla 132 ve 119 hasta alınmıştır. Preoperatif CA125 değeri yüksek olup postoperatif normale gelen hastaların sayısı sırasıyla 54 ve 58 iken bu değeri normalleşmeyen hastaların sayısı 78 ve 61’dir. Her iki CA125 sınır değeri için, postoperatif CA125 değeri normalleşenlerle normalleşmeyen hastalarda hem nükse kadar geçen süre (32 aya karşı 18 ay p:0,015 - 32 aya karşı 17 ay p:0,001) hem de tüm sağkalım açısından (108 aya karşı 36 ay p:0,015 - 89 aya karşı 33 ay p:0,000) istatistiksel anlamlı fark saptanmıştır. Sonuç: Opere over kanseri hastalarından bazal CA125 değeri yüksek saptanan hastalarda ameliyat sonrasındaki düşüşü değerlendirip, bu değerin normal sınırlara düşüp düşmemesine göre nüks süreci hakkında fikir sahibi olunabilinir.

Anahtar Kelimeler:

Over kanseri, CA125, Perioperatif

Clinical Significance of Postoperative CA125 Level Normalization in Operated Ovarian Cancer Patients with High Preoperative Levels

Objective: CA125 is a commonly used tumor marker in ovarian cancer patients for both diagnostic evaluation and follow-up period. In this study, we investigated the clinical importance of postoperative serum CA125 level normalization in ovarian cancer patients with high preoperative levels in terms of recurrence risk and disease free survival. Materials and Methods: We retrospectively analyzed operated ovarian cancer patients who were followed up in medical oncology clinic of Izmir Katip Celebi University Ataturk Training and Research Hospital between years 2005 – 2013. Two different analyses were done according to different CA125 cut-off levels; 35 IU/ml and 65 IU/ml. Results: There are 132 and 119 patients who had basal CA125 levels above normal (cut-off levels were >35 IU/ml and 65 IU/ml respectively). The number of patients who had normalized CA125 levels after surgery was 54 and 58, and who had still high levels was 78 and 61, respectively. For both CA125 cut-off values, there were statistically significant differences in disease free survival (32 month vs. 18 month p:0.015 - 32 month vs. 17 months p:0.001) and overall survival (108 month vs. 36 month p:0.015 - 89 month vs. 33 month p:0.000) between patients with normalized and not normalized postoperative CA125 levels. Conclusion: In operated ovarian cancer patients, who had high preoperative CA125 levels, the decrease in this value postoperatively must be evaluated and normalization of this tumor marker may give us an idea about the recurrence of the disease.

Keywords:

CA125 Ovarian cancer, Perioperative, Recurrence risk,

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