Baş Boyun Kanseri Evrelemesine Güncel Bir Bakış: Geçmiş Kriterlerin Güncel Kriterlerle Karşılaştırmalı Analizi

GİRİŞ: Kanser hastalarının tedavi ve takip algoritmalarının belirlendiği ve American Joint Committee on Cancer (AJCC) tarafından ilan edilen, kanser evreleme kriterlerinin baş boyun kanserleri bölümü 29 yıllık bir aradan sonra yeniden güncellenmiştir. Önceki baskılardaki kriterlerin uzunca bir süre güncellenmemesi sonucu klinik çalışmalarda elde edilen verilerle kanser evreleme sistemi arasında uyumsuz-lukların ortaya çıkmaya başlaması araştırmacıları evreleme sistemini güncellemeye mecbur bırakmıştır. GEREÇ VE YÖNTEMLER: Çalışmamızda AJCC tarafından yayınlanan kanser evreleme kitapçığının 2010 yılında yayınlanan 7. baskısı ve 2017 yılında yayınlanan 8. baskısında yer alan baş boyun kanseri bölümleri detaylı olarak incelenerek değişen veriler ve sebepleri araştırılmıştır. BULGULAR: Yapılan değerlen-dirmede HPV kökenli baş boyun kanserlerinin, tümör invazyon derinliğinin ve lenf nodlarında ekstrakapsüler yayılımın evreleme kriter-lerine önemli etkilerinin olduğu gözlendi. Baş boyun kanseri hastalarında güncellenen kriterlerin çalışmalarda elde edilen verilerle daha uyumlu olduğu, prognoz hakkında daha doğru bilgi verdiği gözlendi. Güncelleme için beklenen süre sonucunda bazı hasta gruplarının agresif, bazı hasta gruplarının ise yetersiz tedavi almak durumunda kaldıkları gözlendi. TARTIŞMA VE SONUÇ: Yenilenen kriterler sayesinde hastalığın prognozu açısından daha sağlıklı bilgi elde edilebilecek, güncellenen tedavi algoritmalarıyla yetersiz veya agresif tedavilerin önüne geçilebilecektir.

A Perspective on Head and Neck Cancer Staging: Comparative Analysis of Past Criteria with Updated Criteria

OBJECTIVE: The treatment and follow-up algorithms of head and neck cancer patients, which was announced by the American Joint Com-mittee on Cancer (AJCC), was revised after an interval of 29 years. The discrepancies between the data obtained in clinical trials and the cancer staging system began to arise and the researchers forced the staging system to be updated, due to the fact that the criteria in the previous editions were not updated for a long time MATERIAL AND METHODS: In our study, the sections of the cancer staging book published by AJCC published in 2010 and the head and neck cancer sections of the 8th edition published in 2017 were examined in detail and the data and reasons were investigated. RESULTS: In the evaluation, it was observed that HPVinduced head and neck cancers had a significant impact on the staging criteria of tumor invasion depth and extracapsular extension in lymph nodes. It was observed that the updated criteria were more consistent with the data obtained in the studies of head and neck cancer patients and gave more accurate information about the prognosis. As a result of the expected time for the update, it was observed that some groups of patients were aggressive and some of the patient groups had inadequate treatment. CONCLUSION: Thanks to the renewed criteria, healthier information can be obtained in terms of prognosis of the disease and inadequate or aggressive treatments can be prevented by the updated treatment algorithms.

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