Nüks alt dudak kanserlerine yaklaşım
Amaç: Bu çalışmada alt dudak kanseri tanısı ile cerrahi, elektrokoagülasyon, kriyoterapi ya da geleneksel lokal tedaviler sonrası lokorejyonel nüks gelişen hastalara uygulanacak tedavi prensipleri tartışıldı.Hastalar ve Yöntemler: Dr. Abdurrahman Yurtarslan Onkoloji Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği’nde, Mart 2002 - Eylül 2007 tarihleri arasında, alt dudak kanseri tedavisi gören ancak takibinde nüks gelişen 16 hastanın 1 kadın, 15 erkek; ort. yaş 58 yıl; dağılım 30-83 yıl kayıtları geriye dönük olarak literatür eşliğinde incelendi.Bulgular: İki hasta kendi merkezimizde tedavi alırken, 14’ü dış merkezlerde, birincil tedavi almıştı. Hastalardan dördünde nüks dudakta, dördünde sadece boynunda, kalan sekizinde ise hem dudak hem de boynunda idi. On hastaya ele gelen lenfadenopati nedeniyle radikal veya modifiye radikal boyun diseksiyonu, üç hastaya da ele gelmeyen lenfadenopati nedeniyle supraomohiyoid boyun diseksiyonu yapıldı, geriye kalan üç N0 boyunlu hastaya ise nüks alt dudak kanseri tanısını takiben eşlik eden ek hastalık nedeniyle boyun diseksiyonu yapılamadı. Ameliyat sonrası birinci yılda yedi hasta %43 alt dudak kanseri nedeniyle ve üç hasta diğer nedenlerden kaybedildi. Altı hasta ilk iki yıl hastalıksız yaşadı.Sonuç: Uygulanacak tedavi hastanın sağkalımını önemli ölçüde etkileyecektir. Birincil alt dudak tümörlü hastalar başvurduğunda lokal tedaviler yerine, onkoloji deneyimi olan KBB hekimlerince cerrahi tedavi planlanmalıdır. Lokorejyonel nüks durumunda ise zaman kaybedilmeden cerrahi tedavi planlanmalıdır
Anahtar Kelimeler:
Dudak kanseri, periost rezeksiyonu, yassı epitel hücreli karsinom, tedavi
Management of recurrent lower lip carcinomas
Objectives: In this study patients who had locoregional recurrence of lower lip carcinomas after therapies such as surgery, electrocoagulation, cryotherapy or traditional local therapies are discussed. Patients and Methods: The records of 16 cases 1 female, 15 males; mean age 58 years; range 30 to 83 years with recurrent lower lip carcinoma admitted between March 2002 and September 2007 to Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ear, Nose and Throat Department were retrospectively reviewed. Results: Fourteen patients had been treated in other institutions, while two had been treated in our center. Four of the patients had recurrence in the lip, four patients had recurrence only in the neck, and the remaining eight patients had both lip and neck recurrence. Ten patients received modified radical or radical neck dissection because of their palpable lymphadenopathies, three patients received supraomohyoid neck dissection due to non palpable lymphadenopathies, and the remaining three patients did not have neck dissection because of co-morbid diseases. Seven patients 43% died in the first postoperative year because of lower lip carcinomas and three patients died because of other reasons. Six patients survived for the first two years without any evidence of disease. Conclusion: Patient survival will be affected by the applied treatment. For patients with primary lower lip cancers, otolaryngologists experienced in oncology must plan surgery rather than local treatments. In case of locoregional recurrence, immediate treatment should be planned.
Keywords:
Lip cancers, resection of periosteum, squamous cell carcinoma, treatment,
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- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi
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