40 Yaş ve Daha Genç Hastalarda Endometrium Kanserleri

Year 2021, Volume: 11 Issue: 3, 357 - 363, 24.05.2021

Gülşah Selvi Demirtaş , Mehmet Gökçü

https://doi.org/10.16899/jcm.887727

Abstract

Amaç: Bu çalışmanın amacı ≤40 yaş kadınlarda endometriyal kanserin (AK) başarılı sonucu ile ilişkili prognostik faktörleri belirlemekti.
Yöntemler: Bu çalışma retrospektif bir kohort çalışmasıdır. 1995 ve 2020 yılları arasında endometriyal küretajda EC tanısı almış ≤ 40 yaşındaki tüm kadınların tıbbi kayıtları gözden geçirildi. Histerektomi yapılan ve son histopatolojik değerlendirmesi hastanemizde yapılan veya tümör kurulu üyeleri tarafından değerlendirilerek hastanemizde takip edilen hastalar çalışmaya dahil edildi.
Bulgular: Medyan takip 79 aydı (9-192 ay). 44 hastadan 42'sine cerrahi müdahale yapıldı. % 33,4'üne (n: 14) total abdominal histerektomi (TAH), bilateral salpingo-ooferektomi (BSO) ve pelvik paraaortik lenf nodu diseksiyonu (PPLND) yapıldı. % 61,9'una (n: 26) TAH BSO ve PLND uygulandı. Bir hastada (% 2.4) sadece TAH, diğerinde (% 2.4) TAH BSO yapıldı. Miyometriyal invazyon kanıtı olmayan doğurganlığını korumak isteyen ve evre 1 endometrioid adenokarsinomu olan 2 hastaya, medikal tedavi uygulandı ve bu hastaların kapsamlı değerlendirmesinde rahim dışında hastalık kanıtı gözlenmedi. 26 (% 59.1) hastada 1. derece, 15 (% 34.1) hastada 2. derece ve 3. (% 6.8) hastada 3. derece adenokarsinom vardı. CA 125 ≥35 IU / ml istatistiksel olarak lenf nodu metastazı (p = 0,004), ˃% 50 miyometriyal invazyon (p = 0,044) ve ileri evre hastalık (p = 0,048) ile ilişkili bulundu.
Sonuçlar: CA 125 ≥35 IU / ml, 40 yaşındaki EC hastalarında istatistiksel olarak lenf nodu metastazı, derin miyometriyal invazyon ve ileri evre hastalık ile ilişkiliydi.

Keywords

CA 125, ENDOMETRİUM KANSERİ, TEDAVİ, GENÇ HASTALAR

Endometrial Cancer in 40 Years Old or Younger: A Single Center Experience

Abstract

Purpose: The purpose of this study was to identify prognostic factors associated with the successful outcome of endometrial cancer (EC) in women aged ≤40 years.
Methods: This was a retrospective cohort study. The medical records of all women aged ≤ 40 years with EC diagnosed on endometrial curettage between 1995 and 2020 were reviewed. Patients who underwent hysterectomy and whose final histopathological evaluation was made in our hospital, or who were evaluated by the members of the tumor board and followed up in our hospital, were included in the study.
Results: Median follow-up was 79 months (range 9-192). 42 of 44 patients underwent surgical intervention. 33,4%(n: 14) underwent total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), and pelvic paraaortic lymph node dissection (PPLND). 61.9% (n:26) underwent TAH BSO, and PLND. In one patient (2,4 %) only TAH and in the other patient (2,4%) TAH BSO was performed. Medical treatment was administered to 2 patients who desired to preserve their fertility and had grade 1 endometrioid adenocarcinoma without any evidence of myometrial invasion and a comprehensive evaluation showed no evidence of extra-uterine disease. 26 (59,1%) patients had grade 1, 15(34,1%) had grade 2, and 3(6,8%) had grade 3 adenocarcinoma. CA 125 ≥35 IU/ml was statistically associated with lymph node metastasis (p=0,004), ˃ 50% myometrial invasion (p=0,044), and advanced-stage disease (p=0,048).
Conclusions: CA 125 ≥35 IU/ml was statistically associated with lymph node metastasis, deep myometrial invasion, and advanced-stage disease in EC patients ≤ 40 years of age.

Keywords

CA 125, , Endometrial cancer, treatment, young patients

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