Koray KOŞMAZ, Mustafa Taner BOSTANCI, Mehmet Ali ÇAPARLAR, Fatih BAŞAK, Abdullah ŞİŞİK, Süleyman KALCAN, Ali Ediz KIVANÇ, Kemal TEKEŞİN, Gürhan BAŞ, Orhan ALİMOĞLU

Mide kanserinde sağkalımı tahmin etmek: 102 hasta ile prospektif kohort çalışma

Amaç: Gastrik kanser, gastrointestinal sistemin en agresif tümörlerinden biridir. Her durumda hastalık seyri farklı olabilir. Bu çalışmanın amacı, mide kanseri hastalarının prognozunu ve sağkalımı etkileyen faktörleri değerlendirmektir.Yöntemler: Gözlemsel kohort çalışması planlandı. Primer mide kanseri hastaları çalışmaya alındı. Nadir tümörleri olan hastalar çalışma dışı bırakıldı. Hastalar 4 gruba ayrıldı; Grup 1: Cerrahiye uygun ve cerrahi rezeksiyon yapılan hastalar, Grup 2: Operasyon sırasında rezeke edilemeyen tespit edilen hastalar, Grup 3: Radyolojik olarak çalışmayan hastalar, Grup 4: Cerrahiyi reddeden hastalar. Gruplar arasında sağkalımı analiz ettik ve etkili faktörleri değerlendirdik.Bulgular: Çalışmaya 102 hasta alındı. Altmış altı hastaya cerrahi rezeksiyon yapıldı (grup 1). Beş hastaya ameliyat sırasında çalışamazlık tanısı kondu (grup 2). Altı genç hasta radyolojik değerlendirme ile inoperabl olarak belirlendi (grup 3). On beş hasta (grup 4) uygun olarak değerlendirildi; ancak ameliyatı reddetti. Cinsiyete göre gruplar arasında fark bulunmadı (P=0,250) (Tablo 1). Bununla birlikte, yaş dağılımı, P=0.043 olan gruplar arasında farklıydı çünkü grup 4, yaş ortalaması 71.0 (10,0) olan yaşlı hastalar tarafından oluşturulmuştur. Sağkalım analizi, grup 1'deki hastaların (14.0 (5,1) ay) diğer gruplardan daha iyi sağkalım gösterdiğini gösterdi (P=0,011). Erkek hastalar kadınlara göre daha iyi sağkalım gösterdi (14 (1,9) vs 6 (1,8) ay, P=0,002).Sonuç: Her ne kadar mide kanseri seyri farklı olsa da, belirli evrelerde uygun cerrahi işlem, kabul edilebilir sağkalım oranları ile uygulanabilir bir tedavi seçeneği gibi görünmektedir.

Anahtar Kelimeler:

Mide kanseri, Sağkalım, Hastalığın seyri

Predicting survival in gastric cancer: A prospective cohort study with 102 patients

Aim: Gastric cancer is one of the most aggressive tumors of the gastrointestinal tract. Course of disease can be different in every case. The aim of this study was to evaluate prognosis of gastric cancer patients and factors affecting survival.Methods: Observational cohort study was planned. Primary gastric cancer patients enrolled into study. Patients with rare tumors were excluded. Patients were divided in 4 groups; Group 1: patients suitable for surgery and underwent surgical resection, Group 2: patients that were discovered unresectable during operation, Group 3: patients that were radiological inoperable, Group 4: patients who refused the surgery. We analyzed survival among groups, and evaluated effecting factors. Results: 102 patients were included in the study. Sixty-six patients underwent surgical resection (group 1). Five patients were diagnosed as inoperable during surgery (group 2). Six-teen patients were determined as inoperable by radiologic evaluation (group 3). Fifteen patients (group 4) were evaluated as operable; however they refused surgery. No differences were detected among groups in comparison of gender with p of 0.250 (table 1). However, age distribution was different between groups with p of 0.043 because group 4 is formed by older patients with mean age of 71.0 (10.0). Survival analysis showed that patients in group 1 (14.0 (5.1) months) had better survival than other groups (P=0.011). Male patients showed better survival than female patients (14 (1.9) vs 6 (1.8) months, P=0.002). Conclusion: Although course of gastric cancer differs in every patient, proper surgery at certain stages seems to be a feasible treatment option with acceptable survival rates.

Keywords:

Gastric cancer, Survival, Course of disease,

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