Cem MİRİLİ, Ali YILMAZ, Mehmet BİLİCİ, Salim BASOL TEKİN

Servikal Kanser Hastalarinin Uzun Dönem Sonuçlari: Doğu Anadolu Tek Merkez Deneyimi

Amaç: Servikal kanser (SK) tüm dünyada kadınlarda kansere bağlı ölümlerin en sık 4. Sebebi iken ülkemizde 12. Sebebidir. En önemli etyolojik neden HPV olması nedeniyle tarama programları ile erken tanı ile kür olma şansı yüksek olan tümörlerdendir. Ancak ülkemizde SK’lerin uzun dönem yaşam verileri ile ilgili bilgiler kısıtlıdır. Bizde çalışmamızda öncelikli olarak SK tanılı hastalarımızın yaşam sürelerini ve bu süreleri predikte eden faktörleri ortaya koymak istedik. Materyal ve metod: Erzurum Atatürk Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Anabilim Dalı'nda 2007-2017 yılları arasında SK nedeniyle takip edilen 70 hasta çalışmaya retrospektif olarakdahil edildi. Genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) ile klinikopatolojik parametreler arasındaki ilişkiler Kaplan-Meier eğrileri kullanılarak analiz edildi ve log-rank testi ile karşılaştırıldı. Tek ve çok değişkenli analiz kriterlerin PFS ve OS için prognostik önemlerini tespit etmek için kullanılmıştır. Bulgular: Hastaların median yaşı 56’dır. En sık görülen histolojik alttip skuamoz hücreli karsinom (%79,5) ardından adenokarsinom (%16,4) gelmektedir. FIGO evreleme sistemine göre hastaların 31’i (%43,8) evre 1-2, 42’si (%56,2) evre 3-4 olarak tanı almıştır. Median PFS ve OS 44 ay ve 78 aydır. 5 yıllık yaşam oranı %37,5 (%12-%75) dur. Histolojik alttiplerin yaşam süreleri arasında fark olmamakla beraber ECOG performans skoru iyi (0-1) olanların, erken FIGO evresi (1-2) olanların, tumor boyutu <4 cm olanların, parametrial ve lenf nodu tutulumu olmayanların hem PFS hem de OS leri daha uzundur. Multivariate analizler sonucunda ECOG performans skoru, parametrial tutulum ve lenf nodu tutulumu PFS ve OS için bağımsız prognostik faktör olduğu tespit edilmiştir. Sonuç: Bölgemizdeki SK’li hastaların tanı anında evreleri daha ileri ve 5 yıllık yaşam oranları dünya ortalamalarının altındandır bu sebeple kadınlarımızın bu konuda daha iyi bilinçlendirilmeleri gerekmektedir

Anahtar Kelimeler:

Servikal kanser, HPV, Prognostik faktörler

Long-Term Follow-Up Outcomes of Cervical Cancer Patients: A Single Center Experience from the East Anatolian Region of Turkey

Objective: Cervical cancer (CC) is the 4th most common cause of cancer-related deaths in women all over the world. The most important etiologic cause is HPV, and this allows tumor to have high chance of curing with early diagnosis by screening programs. However, information about long-term survival data of CC is limited in our country. In our study; we wanted to reveal the survival times of our patients with CC and the factors that predict these times.Material and methods: Seventy-three patients with CC, followed between 2000 and 2017 were analyzed retrospectively. Associations between clinical and histopathological parameters with overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan- Meier curves and compared by the log-rank test. Univariate and multivariate analysis were used to assess their prognostic values for PFS and OS.Results: The median age of the patients was 56 years. The most common histological subtype was squamous cell carcinoma (79.5%) followed by adenocarcinoma (16.4%).According to FIGO staging system, 31 (43.8%) of the patients were diagnosed as stage 1-2 and 42 (56.2%) were as stage 3-4.The median PFS and OS are 44 months and 78 months. The 5-year survival rate is 37.5% (12%-75%). Although there was no difference in length of life between histological subtypes, both PFS and OS were longer in patients with good ECOG performance score (0-1), early FIGO stage (1-2), tumor size <4 cm, and without parametrial and lymph node involvement. Multivariate analysis showed that ECOG performance score, parametrial involvement and lymph node involvement were independent prognostic factors for PFS and OS. Conclusion: The stage at time of diagnosis of CC patients in our region is more advanced and their 5-year survival rates are below the world average, so our women need to be better informed about this subject.

Keywords:

Cervical Cancer, HPV DNA, Prognostic factors,

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