Evre I invaziv serviks karsinomları: SSK Ege Doğumevi ve Kadın Hastalıkları Eğitim Hastanesi deneyimi
Evre I serviks kanseri nedeniyle tedavi edilen olgularda rekürrens riskini arttıran faktörlerin incelenmesi ve yaşam şansının belirlenmesi. S.S.K. Ege Doğumevi ve Kadın Hastalıkları Eğitim Hastanesi Onkoloji Departmanı. 1986-1996 yılları arasında serviks karsinomu tanısı alan 443 olgudan FIGO sınıflamasına göre evre I grubunda 117 olgu (% 26.4) tedavi edildi. Risk faktörü taşıyan 77 (% 66) olguya radyoterapi uygulandı. Uygulanan tedavi modaliteleri, histolojik tip, lenf nodu tutulumu, invazyon bulguları ve rekürrensler dökümante edildi. 103 olguda (%88.4) epidermoid karsinom, 13 olguda (%10.7) adenokarsinom ve 1 olguda (%0.9) sarkom saptandı. 14 olgu evre Ia1, 9 olgu evre Ia2 ve 94 olgu evre Ib olarak değerlendirildi. İnvazyon derinliği arttıkça rekürrens ve lenf nodu tutulumunun arttığı gözlendi. Seride 5 yıllık yaşam şansı %88.56 olarak hesaplandı.
Stage I invasive cervix carcinoma: SSK Ege Maternity Hospital experience
To assess the risk factors that increase the recurrence rate in the cases treated for stage I cervical cancer. Department of Gynecologic Oncology, SSK Ege Maternity Teaching Hospital. 117 FIGO stage I cervix carcinoma cases were treated between 1986 and 1996 in our clinic. 64.9% (76/117) of the patients primarily underwent radical hysterectomy and pelvic-paraaortic lymphadenectomy, while radiotherapy was performed to 66% (77/117) cases as primary or adjuvant treatment modality. Treatment modalities, histologic type, lymph node involvement, invasion findings, and recurrences were documented. Epidermoid carcinoma was found in 103 patients (88.4 %), adenocarcinoma in 13 (10.7 %) and sarcoma in one (0.9%). Fourteen cases were stage Ia1, eight were stage Ia2 and 94 were stage Ib. Lymph node involvement was observed in 41% of the cases having parametrial involvement. Genitourinary fistula was the most encountered morbidity with the rate of 3.9 %. It is recognised that recurrence and lymph node involvement rates increase when the depth invasion increases. 5-year survival rate was found as 88.56 % in our series.
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- 1. Armstrong BK, Munoz N, Bosch FX: Epidemiology of cancer of the cervix. İn Coppleson M (ed), Gynecologic Oncology, 2nd Edition, Volume 1 Churchill bringstone, Edinburg London 1992;11.
- 2. Aydınlı K, Bozkurt S, Erkin E, Atasü T: Kadın Genital Kanserleri Insidansı. Jinekoloji ve Obstetrik Dergisi1987; 1:33.
- 3. Ayhan A, Tuncer ZS, Koseoglu F, Yüce K, Kucukali T: Microinvasive carcinoma of the cervix: an analysis of 31 patients. Eur J Gynaecol Oncol 1997;18(2):127-129
- 4. Güner H, Serviks Kanseri, Jinekolojik Onkoloji 1994.
- 5. Ceardin E, Schmidt RW, Robrets JA. Prognostic factors and relapse patterns in early stage cervical carcinoma after brachitheraphy and radikal hysterectomy. Gynecol. Oncol 1994;53 (3):317-319.
- 6. Disaia PJ, Creasman WT, Clinical Gynecologic Oncology. The C. V. Mosby Co. 1984;chapter 3.
- 7. Burke TW, Haskins WJ, Heller PB, Bibram C, Wanser EB. Clinical patterns of tumor recurrence after hysterectomy in stage IB cervical carcinoma. Obstet. Gynecol. 1987;69: 382.
- 8. Wright TC, Kurman RJ, Ferenczy A: Precancerous Lesions of the cervix. İn Kurman RJ (ed): Blaustein's pathology of the female genital tract. 4. Ed. Springer Verlag, New York, 229, 19
- 9. Piver MS, Rose Freedman MF: Changes in FIGO staging. Am. J Obstet Gynecol 1988:158:678.
- 10. Burghardt E, Girardi F: Local spread. İn Burghardt E (ed), Surgical Gynecologic Oncology, Georg Thieme Verlag 1993;203-212.
- 11. Schmidt MH, Kühnle H: Paeneoplasien und Neoplasien der Cervix Uteri. Klinik der Frauenheilkunde und Geburtshilfe, Band 11, Urban und SchWarzenberg, München, 1991 ;3:129.
- 12. Gilly G, Gilly L: Lungen und Knochenmetastasen bei malignen Uterustumoren Geburtshu Frauenheilk 1969;29:505.
- 13. Lee Y, Wang KL, Lin MH, Liu CH: Radical hysterectomy with pelvic lymph node dissection for treatment of cervical cancer; A clinical revieW of 954 cases. Gynecol Oncology 1989; 32:135-142.