ALİ GÖKYER, AHMET KÜÇÜKARDA, Osman KÖSTEK

PÜR SEMİNOM VAKALARININ KLİNİK ÖZELLİKLERİ VE TEDAVİ SONRASI İZLEMLERİ: TEK MERKEZ DENEYİMİ

Amaç: Pür seminom erken evrede tanı konan, genellikle genç erişkinlerin en önemli tümörüdür. Yüksek kür oranları radyoterapi veya kemoterapi ile yakalanabilir. Tedavi kararı verirken toksisite sorunları ve hasta tercihleri göz önüne alınmalıdır. Çalışmamızda kliniğimizde takip edilen pür seminomlu hastaların verilerini ve sağkalımlarını sunmayı amaçladık. Materyal ve Metot: 2008-2018 yılları arasında kliniğimizde tedavi ve takip edilen pür seminom tanılı hastaların dosyaları retrospektif olarak incelendi. Hasta özellikleri, tümör özellikleri, tedavi rejimleri, tedavi sonrası prognoz ve takipleri kayıt edildi. Bulgular: Kliniğimizde takip edilen 125 hastadan 86’sı (%68,8), 20-40 yaş aralığında seminom tanısı almıştı. Tümör lokalizasyonu genellikle sol testis’ti (%57,6). Tanı anında 102 hasta (%81,6) evre 1, 14 hasta (%11,2) evre 2 ve 9 hasta (%7,2) evre 3 idi. Tanı anında sadece 5 hastada metastaz saptandı. Tedavi olarak 63 hastaya kemoterapi, 39 hastaya radyoterapi uygulanırken, 23 hasta da tedavisiz izlendi. Takipte 10 yılı dolduran 45 hastada %88,9 saptandı. Takip edilen hastalar içinde 6 hasta eksitus oldu. 4 hasta ilk 2 yıl içerisinde hastalık nüksü ve tedavi yanıtsızlığı nedenli kaybedildi. Eksitus olan 6 hasta içinde öne çıkan özellikler ileri evre hastalık ve akciğer parankim nüksü olmasıdır. Sonuç: Evre 1 seminomlu hastaların tedavi seçenekleri arasındaki genel sağ kalım ve nüks açısından belirgin fark izlenmedi. Akciğer parankim nüksü ve ileri evre hastalık mortalite ile ilişkiliydi.

CLINICAL FEATURES AND FOLLOW-UP OF PURE SEMINOMA CASES: SINGLE CENTER EXPERIENCE

Aim: Pure seminoma which is diagnosed in early stages is the most important tumor seen in young adults. Toxicity problems and patient preferences should be taken into consideration when making treatment decision. We aimed to present the data and survival rates of patients with pure seminoma who has been followed in our clinic. Materials and Methods: Documents of the pure seminoma patients who has been followed and treated in our clinic between the years of 2008 and 2018 were studied retrospectively. Patient features, tumour features, treatment regimens, prognosis and folow up after treatment were recorded. Results: 86 of 125 patients(68,8%) who has been followed in our clinic with the diagnosis of seminoma were between the ages of 20 and 40. At the time of diagnosis,102 patients(81,6%) were at stage 1,14 patients(%11,2) were at stage 2 and 9 patients(7,2%) were at stage 3 disease. Metastases were detected in only 5 patients at the time of diagnosis. While 63 patients were treated with chemotherapy and 39 patients were treated with radiotherapy. Survival rate was 88,9% for 45 patients who filled in 10 years follow up time. 6 patients died because of disease recurrence and irresponsiveness to the therapy. The prominent features in deceased patients were late stage disease and lung parenchymal recurrence. Conclusion: Different treatment modalities for stage 1 disease were similar in aspect of overall survival. Pulmonary parenchyma recurrence and advanced stage disease were associated with mortality.

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