Arzu AKŞAHİN, Uğur ERSOY, Dilşen ÇOLAK, Doğan YAZILTAŞ, İnanç İMAMOĞLU, Berkant SÖNMEZ, Mustafa ALTINBAŞ

Kolorektal kanserlerde semptomların dağılımı ve sağ kalım

Amaç: Hastanemize kolorektal kanser nedeniyle başvuran hastaların semptom ve bulguların dağılımı ile sağ kalımlarını değerlendirmek istedik. Yöntem ve Gereçler: Tıbbi Onkoloji Kliniğine, Ocak 2008 ve Haziran 2010 tarihleri arasında başvuran 182 hastanın dosyalarını retrospektif olarak inceledik. Hastaların tedavi öncesindeki semptomlarını, hasta ve tümör özelliklerini belirledik. Yapılan tedavileri saptadık. Tedavi sonrası bir ve iki yıllık sağ kalım analizlerini yaptık. Bulgular: Hastalarımızın çoğu erkek (kadın / erkek oranı 1.46) ve rektosigmoid bileşke tümörleri %65 oranında idi. En sık görülen semptom karın ağrısı olup sonra kanama ve kabızlık geliyordu. Daha az olarak anemi, ileus ve ishal gözlenmişti. Hastalarımızın bir yıllık sağ kalım analizinde evre I ve II hastaların %100’ü halen yaşıyordu. Evre III’de sağ kalım oranı %93.3 ve evre IV’de %73.2 olarak bulundu. İki yıllık takibi yapılabilen 82 hastamızdan evre I’de 4 hasta (%100) yaşıyordu. Evre II’de 30 hastanın iki yıllık takibi oldu ve 6’sı ex olmuştu. Evre III’de 29 hastanın iki yıllık takibi vardı ve 7’si ex olmuştu. Evre IV’de 19 hastanın iki yıllık takibi olup 11’i ex olmuştu. Sonuç: Hastaların semptom ve bulgularının daha dikkatli irdelenmesinin gerekliliğine inanıyoruz. Sağ kalım verileri literatüre uygun olarak evre ve performans ile korelasyon gösterdi (p

Symptom distribution and survival in colorektal cancers

Aim: In this study, we aimed to evaluate effect of pathologic and clinical findings of patients to overall survival who admitted to our oncology clinic with colorectal cancer. Material and Methods: We retrospectively evaluated 182 patients who admitted to our Medical Oncology Clinic between January 2008 and June 2010. Sings of symptoms of patients before therapy have been evaluated and 1 and 2 year survival analysis has been performed. Results: Male to female ratio was 1.46, in 65 % of patients tumor was located in recto-sigmoid region. The most common symptoms were abdominal pain, hemorrhage and constipation, respectively. Anemia, ileus and diarrhea were seen less commonly. One-year survival for stage I and II were 100 %, for stage III it was 93.3 % and for stage IV it was 73.2 %. 82 patients could be followed for two year. 2 year survival for stage I was 100 %, for stage II it was 80%, for stage III it was 75.8 %, for stage IV it was 42.1 % Conclusion: For early diagnosis of colorectal cancers, sings and symptoms should be evaluated carefully. As in literature, our survival analysis shows that stage and performance status are important prognostic factors. For accurate interpretation of survival statistics, 3 and 5-year survival rates would be more suitable.

PDF

___

1. Jeong SY, Park JW. Colorectal cancer. In Tuncer AM. Asian pacific for cancer prevention cancer report. Ankara New hope in health 2010. p.197–8.
2. Tuncer M, Ozgul N.Turkey. In Tuncer AM asian pacific for cancer prevention cancer report. Ankara New hope in health 2010. p. 414–8.
3. Jemal A, Siegel R, Ward E, et al. Cancer statististics, 2009. CA Cancer J Clin. 2009; 59: 225–9.
4. Burke HB. Outcome prediction and the future of the TNM staging system. J Natl Cancer Inst. 2004;96: 1408–9.
5. Green RJ, Metlay JP, Propert K, et al. Surveilance for second primary colorectal cancer after adjuvant chemotherapy: An analysis of İntergroup 0089. Ann Intern Med 2002;136:261–9.
6. Libuti SK, Saltz LB, Tepper JE, colon cancer. In Devita VT, Lawrence ST, Rosenberg SA. Cancer principles and practice of oncology 8thed. Philadelphia Lippincott Wiliams and Wilkins. 2008:p:1233–85.
7. Tan BR. Gastrointestinal cancer colorectal and anal. In Govindan R. The Washington manual of oncology. Second edit. Lippincott Wiliams and Wilkins. 2008:p:190–204.
8. Jessup JM, McGinnis LS, Steele GD, et al. The National Cancer Data Base. Report on colon cancer. Cancer. 1996;78: 918–26.
9. Benson AB. Epidemiyology, disease progression, and economic burden of colorectal cancer. J of manag care pharm 2007:13;(suppl s-c) s5-s18.
10. Gunderson LL, Jessup JM, Sargent DJ, et al. Revised categorization for colon cancer based on national survival outcomes data. J Clin Oncol. 2010;28 (2):264–71.
11. Jessup JM, McGinnis LS, Steele GD, et al. The National Cancer Data Base. Report on colon cancer. Cancer. 1996;78: 918-26.
12. Jemal A, Siegel R, Xu J, and Ward E, Cancer Statistics, 2010. CA Cancer J Clin 2010; 60: 277–300.
13. Tan BR. Gastrointestinal cancer colorectal and anal. In Govindan R. The Washington manual of oncology. Second edit. Lippincott Wiliams and Wilkins. 2008: p:190–204.
14. Majumdar SR, Fleetcher RH, Evans A. How does colorectal cancer presnt? Symptoms, duration, and clues to lokation. Am j Gastroenterol 1999, 94: 3039–45.
15. Stein W, Farina A, Gaffney K, et al. Characteristics of colon cancer at time of presentation. Fam Pract Res J 1993;13: 355-60.