Adem BAYRAKTAR, Metin KESKİN, Cemil Burak KULLE, Gülçin YEĞEN, Emre BALIK, Mehmet Türker BULUT

ERKEN EVRE MİDE KANSERİNDE RADİKAL CERRAHİ: İSTANBUL ÜNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ DENEYİMİ

Amaç: Mide kanseri nedeniyle radikal cerrahi uygulanan olgular arasında erken evre mide kanseri sıklığı ve bu olgularda postoperatif erken ve geç dönem sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmada 2006–2013 yılları arasında mide kanseri nedeniyle radikal cerrahi uygulanan 391 olgudan, histopatolojik değerlendirme sonucunda erken evre mide kanseri saptanan 39 olgunun demografik verileri, patolojik bulguları ve klinik sonuçları retrospektif olarak incelenmiştir. Bulgular: Morbidite 13 (%33) hastada izlenirken, mortalite görülmedi. İnvazyon derinliği olguların 26’sında (%67) submukozal, 13’ünde (%33) intramukozal idi. Hastaların 11’inde (%28) lenf nodu metastazı saptanmıştır. İntramukozal yerleşimli tümörlerde lenf nodu metastazı oranı %14’iken submukozal tümörlerde bu oran %34,6’ya çıkmaktaydı. Ortalama takip süreleri 73,6 ay (48-111 ay) idi. Uzun dönem takiplerinde 4 olguda (%10) hastalık nüksü saptanırken 3 olgu (%7,5) ise eks olmuştur. Olguların 35’i (%89,7) hastalıksız olarak takip edilmektedir. Sonuç: Uzak Doğu Ülkelerine kıyasla, çalışmamızda erken evre mide kanseri prevelansı daha düşük olarak bulunmuştur. Bununla birlikte, erken evre mide kanserinde lenf nodu tutulumunun daha yüksek olduğu saptanmıştır. Japon Endoskopik Tedavi Kılavuzuna göre hastaların sadece %1,8’i endoskopik rezeksiyona uygun bulunmuştur. Bu veriler doğrultusunda, ülkemizde radikal cerrahinin erken evre mide kanseri için en uygun tedavi seçeneği olduğunu düşünüyoruz.

Anahtar Kelimeler:

Erken evre mide tümörü, metastatik lenf nodu, radikal cerrahi

RADICAL SURGERY IN EARLY STAGE GASTRIC CANCER: SINGLE CENTER EXPERIENCE

Objective: This study was performed to determine the overall early stage gastric cancer (ESGC) prevalence and to evaluate the short- and long-term postoperative outcomes of patients with ESGC who underwent radical surgery. Method: All 391 gastric cancer patients who underwent radical surgery between 2006 and 2013 were included in the study. Thirty nine patients who were diagnosed with ESGC were evaluated retrospectively in terms of demographics, pathological findings and clinical outcomes. Results: Thirteen (33%) patients had morbidity and mortality rates of zero. The depth of tumor invasion was submucosal in 26 (67%) patients, intramucosal in 13 (33%). Eleven (28%) patients had lymph node involvement. While lymph node involvement rate in intramucosal tumors was 14%, the rate rose up to 34.6% in submucosal tumors. The average follow-up period was 73.6 months. The long term outcomes in 4 (10%) patients had a recurrence and 3 (7.5%) patients died. 35 (%89.7) patients are being monitored tumor-free at the time of publication. Conclusion: When compared to Asian countries, the prevalence of ESGC was lower in our study. However, lymph node involvement in ESGC was higher. Only 1.8% of patients were found appropriate for endoscopic resection according to the Japanese Endoscopic Treatment Guidelines. In light of these findings, we find that radical surgery is an appropriate treatment choice for ESGC in our country.

Keywords:

Early stage of gastric cancer, metastatic lymph nodes, radical surgery,

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