HAMDULLAH SÖZEN, Merve BAKTIROGLU, Harika YUMLU, İrem USTA, İbrahim YALÇIN, KAMURAN İBİŞ, Seden KÜÇÜCÜK, Samet TOPUZ, Yavuz SALİHOĞLU

Serviks Kanserinde Primer Kemoradyoterapi Sonrası Uterusta Sınırlı Rezidu Tümörün Sağkalıma Olan Etkisi

Amaç: Primer kemoradyoterapi tedavisi almış ileri evre serviks kanserli hastalarda uterusa sınırlı rezidü tümör miktarının sağkalıma etkisini belirlemek ve bu tarz tümörlerde görüntüleme yöntemlerinin rezidü tümör saptamadaki başarısı saptamak. Gereçler ve Yöntem: İstanbul Universitesi İstanbul Tıp Fakültesi Jinekolojik Onkoloji Kliniğinde 2009 Nisan-2017 Mayıs ayları arasında opere edilen 31 hasta çalışmaya dahil edilmiştir. Bu hastaların klinikopatolojik özellikleri değerlendirilmiştir. Hastalar operasyon öncesi Magnetik Rezonans inceleme (MRI) ve/veya Pozitron Emisyon Tomografi (PET-BT) ile değerlendirilmiştir. Hastalar operasyon sonrası uterus materyalinde tümör miktarına göre i) rezidu tümör yok ii) rezidü tümör 10 mm olarak üç gruba ayrılmış ve hastalıksız sağkalım incelemesi yapılmıştır. Bulgular: Ortanca yaş 54 olarak hesaplanmıştır. MRI rezidü tümör saptamada sensitivitesi %75 spesifitesi %50 ; PET-BT sensitivitesi %54.5 spesifitesi %50 olarak saptanmıştır. Bir yıllık hastalıksız sağkalım oranları rezidü olmayan, mikroskobik rezidü olan ve makroskobik rezidü olan hastalarda sırası ile %92.3, %80 ve %38.5 olarak tespit edildi. Sonuç: Irradiye serviks kanserinde rezidü tümör saptamada görüntüleme yöntemlerinin başarısı kısıtlıdır. Histopatolojik olarak saptanmış rezidü tümörün büyüklüğü arttıkça hastalıksız sağkalım rakamları azalmaktadır.

The Survival Effect of Residual Disease on Hysterectomy Specimen Among the Patients Previously Treated by Chemoradiotherapy

Objective: to determine the association between the life prospects and residual tumour size on hysterectomy specimen among the group of patients previously treated by primary chemoradiotherapy. Secondary aim of the study is to investigate the success of imaging methods on the same group of patients. Material and Methods: thirty one patients operated at istanbul university istanbul medical faculty between 2009 april and 2017 october due to insuffient treatment after primary chemoradiotherapy are recruited. Clinicopatholigical features of these patients were evaluated. Patients are categorized according to residual tumour size on hysterectomy specimen i) no residual tumour in specimen ii) residual tumour size under 10 mm iii) residual tumour size more than 10 mm. Results: Median age is calculated as 54 . Sensitivity and specifity of magnetic resonance investigation are found 75 percent and 50 percent whereas pozitron emission tomography sensitivity and specifity are calculated as 54 and 50 percent espectively. One year disease free survival of no tumour group, microscopic tumour group and macroscopic tumour group are calculated 92 , 80, 38 percent, respectively. Conclusion: The success of imaging methods on determining residual tumour in uterus is limited. Increasing size of residual tumour proven by histopathological method on uterus is associated with worse prognosis.

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