Murat ÖZ, İlker SELÇUK, Zeliha Fırat CÜYLAN, Hüseyin AKILLI, Ali AYHAN

REKÜRREN EPİTELYAL OVER KANSERİNİN CERRAHİ YÖNETİMİ

Epitelyal over kanseri’nin (EOK) standart yönetim şekli primer sitoredüktif cerrahi ve ardından verilen intravenöz platin tabanlı kemoterapidir. İlk tedavi sonrası hastaların büyük bölümünde remisyon görülmesine rağmen ileri evre hastalıkta nihayetinde hastaların tamamına yakını nüksetmektedir. Rekürren EOK’de henüz standartlaşmış bir yönetim şekli yoktur. Nüks hastaların değerlendirilmesi ve tedavi şekli mutlaka bireyselleştirilmelidir. Nüks tanısı alan hastanın önünde iki seçenek vardır. Birincisi platin duyarlılığına göre belirlenecek kemoterapi rejiminin alınması, ikincisi ise sekonder sitoredüksiyon (SSR) girişiminin ardından verilecek adjuvan kemoterapi. Henüz iki yöntem de standart yönetime girmiş değildir, çünkü bu konuya açıklık getirecek kanıtlar henüz olgunlaşmamıştır. Bu derlemede son literatür ışığında rekürren EOK hastalarında SSR girişiminin rasyoneli ve şimdiye dek yapılmış çalışmalar irdelenerek tedavinin bireyselleştirilmesi ve hasta seçimi konusunda güncel yaklaşım oluşturulmaya çalışılacaktır.

Anahtar Kelimeler:

Rekürren over kanseri, kemoterapi, sekonder sitoreduksiyon

SURGICAL MANAGEMENT OF RECURRENT EPITHELIAL OVARIAN CANCER

Primary cytoreductive surgery followed by platinum based intravenous chemotherapy is the mainstay of the treatment in epithelial ovarian cancer (EOC). Most of the patients Show complete remission after the initial therapy. However, patients with advanced stage disease will eventually recur. There is not a standardized management for recurrent EOC. The management and therapeutic options should be highly individualized for recurrent EOC patients. There are two majör options fort he patients with recurrent EOC: first option is intravenous chemotherapy, which should be established according to the platinum sensitivity of the tumor. Second option is adjuvant intravenous chemotherapy followed by secondary cytoreductive surgery (SCR). Due to lack of high quality evidence, there is not a standard approach for recurrent EOC. In the review article, we evaluated the rationale in the management of recurrent EOC and tried to establish a current approach for individualizing the management and patient selection for SCR in EOC.

Keywords:

recurrent ovarian cancer, chemotherapy, secondary cytoreduction,

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