Erken evre endometriyum kanserinde prognostik faktörlerin belirlenmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amac?: Bu çalışmanın amacı erken evre endometriyum kanseri olgularında prognostik faktörleri belirlemektir. Gerec? ve Yöntem: Ocak 2011- Aralık 2022 tarihleri arasında, İnönü Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde opere edilen ve takibi yapılan endometrium kanseri olguları retrospektif olarak tarandı ve bu olgular içerisinde FIGO evrelemesine göre erken evre (Evre Ia, Ib ve II) olan 241 hasta değerlendirmeye alındı. Bulgular: Çalışmamıza dahil edilen hastaların median yaşı 57 olup (en düşük: 34 -en yüksek: 86), 181 hastada (%75.10) evre Ia, 47 hastada (%19.50) evre Ib ve 13 hastada (%5.40) ise evre II endometriyal kanser saptandı. Gravida, parite, serum CA-125 seviyeleri ve histolojik derecenin mortalite gelişmeyen hasta grubunda anlamlı şekilde yüksek olduğu saptandı (sırasıyla p=0.011, p=0.047, p<0.001 ve p=0.029). Univariate regresyon analizinde artmış serum CA-125 düzeyleri [Hazard ratio (HR), 1.009; 95% Confidence Interval (CI), 1.003–1.016; p=0.004)], artmış hastalık evresi (HR, 2.69; %95 CI, 1.009–6.722; p=0.048) ve artmış histolojik grade'in (HR, 4.85; %95CI, 1.35–17.40; p=0.015) daha kısa genel sağkalım (OS) ile ilişkili olduğu saptandı. Multivariate analiz, histolojik grade'in hem OS'ı hem hastalıksız sağkalım (DFS)'ı bağımsız olarak öngördüğü sonucunu ortaya koydu (sırasıyla HR, 5.942; %95CI, 1.593–22.158; p=0.008; HR, 4.830; %95CI, 1.487–15.687; p=0.009). Sonuc?: Çalışmamız erken evre endometrial kanser hastalarında histolojik tümör grade'inin hem OS hem de DFS için bağımsız belirleyici olduğu sonucunu ortaya koydu. Bu çalışmanın bulguları erken evre endometriyum kanseri vakalarında intraoperatif frozen kesit analizinde yüksek histolojik tümör grade'i saptanması durumunda kapsamlı bir değerlendirme sağlamak için tam bir cerrahi evreleme yapılması gerektiği önermesini desteklemektedir. Anahtar Kelimeler: CA-125 antijeni, Endometriyum Kanseri, Hastalıksız sağkalım, Prognoz, Sağkalım analizi.
Objective: The objective of this study is to investigate the prognostic factors associated with early stage endometrial cancer. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with early stage (Stage Ia, Ib, and II) endometrial cancer who underwent surgery and follow-up at the Obstetrics and Gynecology Department of İnönü University between January 2011 and December 2022. Results: The median age of the patients enrolled in the study was 57 (ranging from 34 to 86). Among the patients, 181 (75.10%) were classified as stage Ia, 47 (19.50%) as stage Ib, and 13 (5.40%) as stage II endometrial cancer. Several factors, including gravida, parity, serum CA-125 levels, and histological grade, were significantly higher in the patient group without mortality (p=0.011, p=0.047, p<0.001, and p=0.029, respectively). Univariate regression analysis revealed that increased serum CA-125 levels [Hazard ratio (HR) 1.009; 95% Confidence Interval (CI) 1.003-1.016; p=0.004)], higher disease stage (HR2.69; 95%CI 1.009-6.722; p=0.048), and elevated histological grade (HR4.85; 95%CI 1.35-17.40; p=0.015) were associated with overall survival (OS). Multivariate analysis demonstrated that histological grade independently predicted both OS and disease-free survival (DFS) (HR5.942; 95%CI 1.593-22.158; p=0.008; HR4.830; 95%CI 1,487-15,687; p=0.009), respectively. Conclusion: This study highlights the independent predictive value of histological tumor grade for OS and DFS in early stage endometrial cancer patients. These findings emphasize the importance of performing comprehensive surgical staging in cases where a high histological tumor grade is detected during intraoperative frozen section analysis, ensuring a comprehensive assessment for early-stage endometrial cancer. Keywords: CA-125 Antigen, Disease-free survival (DFS), Endometrial cancer, Survival Analysis, Prognosis
Objective: The objective of this study is to investigate the prognostic factors associated with early stage endometrial cancer. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with early stage (Stage Ia, Ib, and II) endometrial cancer who underwent surgery and follow-up at the Obstetrics and Gynecology Department of İnönü University between January 2011 and December 2022. Results: The median age of the patients enrolled in the study was 57 (ranging from 34 to 86). Among the patients, 181 (75.10%) were classified as stage Ia, 47 (19.50%) as stage Ib, and 13 (5.40%) as stage II endometrial cancer. Several factors, including gravida, parity, serum CA-125 levels, and histological grade, were significantly higher in the patient group without mortality (p=0.011, p=0.047, p<0.001, and p=0.029, respectively). Univariate regression analysis revealed that increased serum CA-125 levels [Hazard ratio (HR) 1.009; 95% Confidence Interval (CI) 1.003-1.016; p=0.004)], higher disease stage (HR2.69; 95%CI 1.009-6.722; p=0.048), and elevated histological grade (HR4.85; 95%CI 1.35-17.40; p=0.015) were associated with overall survival (OS). Multivariate analysis demonstrated that histological grade independently predicted both OS and disease-free survival (DFS) (HR5.942; 95%CI 1.593-22.158; p=0.008; HR4.830; 95%CI 1,487-15,687; p=0.009), respectively. Conclusion: This study highlights the independent predictive value of histological tumor grade for OS and DFS in early stage endometrial cancer patients. These findings emphasize the importance of performing comprehensive surgical staging in cases where a high histological tumor grade is detected during intraoperative frozen section analysis, ensuring a comprehensive assessment for early-stage endometrial cancer. Keywords: CA-125 Antigen, Disease-free survival (DFS), Endometrial cancer, Survival Analysis, Prognosis
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
