EVRİM BOSTANCI ERGEN, SELÇUK AYAS, Telce Ayşen GÜRBÜZ, Ayşe GÜRBÜZ, Ateş KARATEKE

Uterus sarkomlu 29 olgunun retrospektif analizi: Tek merkez deneyimi

Amaç: Uterus sarkomlu olguların evrelerine, histolojik tiplerine ve uygulanan tedavi yöntemlerine göre rekürrens ve sağkalım oranlarının ortaya konulmasıdır. Yöntemler: Çalışmaya 2001- 2011 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Hastanesi Jinekoloji servislerinde uterin sarkom tanısı alan 29 olgu dahil edildi. Hastaların dosyalarına ulaşılarak retrospektif olarak sosyodemografik veriler, hastalığın tanı ve tedavi süreçlerinde uygulanan yöntemler araştırıldı. Hastalar aranarak hastalığın progresyonu, sağkalım süreleri, rekürrens durumları öğrenildi. Bulgular kayıt edilerek istatiksel olarak analiz edildi. Bulgular: Hastaların tanı anındaki ortalama yaşı 51,2 (±13SD) olarak saptandı. Olguların %68,9 u postmeno- pozal dönemde tanı aldı. Hastaların en sık (%72,3) başvuru şikayeti vaginal kanama idi. FIGO 2009 a göre evrelenen hastaların %51,7 sinin evre 1, %34,4 ünün evre 3 olduğu saptandı. Olguların yirmiikisine (%75,8) total abdominal histerektomi(TAH) + bilateral salpingo ooferektomi (BSO)+ omentektomi + bilateral pelvik- paraaortik lenf nodu diseksiyonu (BPPLND) yapıldı. Ortalama tümör büyüklüğü 10,2(±8,5) cm olarak saptandı. Olguların %34,4 (n=10) ünde lenf nodu tutulumu mevcuttu. Operasyon sonrası ortalama yaşam süresi 3,2 yıl olarak hesaplandı. Verilerin toplandığı Aralık 2013 tarihine kadar oniki olgu (%41,37) eksitus oldu. Sonuç: Uterus sarkomları erken evrede bile prognozu kötü olan tümörlerdir. Her bir histolojik tip ayrı ayrı değerlendirilmelidir. Adjuvan tedavilerin rolü tartışmalıdır.

Retrosp ective analysis of 29 cases with uterine sarcoma: A single center exp erience

Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages, treatment methods, histological type. Methods: In this study 29 patients were included who were diagnosed with uterine sarcoma at Zeynep Kamil Women and Children Diseases Hospital between 2001 and 2011. Demographic data of patients, treatment and diagnosis process were investigated retrospectively by accessing the file of patients. Disease progression, survival time, recurrence status was learned by calling. Results were analyzed statistically. Results: Average age of patients were 51, 2 (± 13SD). Most of the patients were in postmenopausal (n=20, 68.9%). The most frequently (72.3%) complain was vaginal bleeding. 51.7% of patients were stage I and 34.4% of patients were stage 3 according to staging FIGO 2009. Twenty-two of the patients were treated with total abdominal hysterectomy (TAH)+ bilateral salpingo-oophorectomy (BSO)+bilateral pelvic and paraaortic lymphadenectomy (BPPLND) and omentectomy. Mean tumor size were 10, 2(±8.5) cm. 34,4% of patients (n = 10) patients had lymph node involvement. Respectively, after the operation, the average life expectancy of 3.2 years. Twelve patients (41.37%) died until data collected up to December 2013. Conclusion: Uterine sarcomas have poor prognosis even at early stages. Each histological type must be evaluated separately. The role of adjuvant therapy is controversial.

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