Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde klinikopatolojik özellikler ve prognoz

Year 2023, Volume: 23 Issue: 3, 44 - 51, 28.12.2023

Merve Çakır Köle , Aysun Alcı , Alper Kahraman , Mustafa Gökkaya , Necim Yalçın , Selim Kandemir , Mehmet Göksu , İsin Ureyen , Tayfun Toptaş

https://doi.org/10.59215/trsgo.1282732

Abstract

Amaç: Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde klinikopatolojik özellikler ve prognozun araştırılması.

Gereç ve yöntemler: Bu çalışma, Ocak 2015 ile Aralık 2021 tarihleri arasında tek bir merkezde ameliyat edilen, senkron veya metakron tanı konmuş, jinekolojik olmayan primer bölgelerden over metastazı olan ardışık hastaları içeren retrospektif bir çalışmadır. Hastaların klinikopatolojik özellikleri hasta dosyalarından ve elektronik veri tabanından elde edilmiş ve Cox orantılı hazard modelleri kullanılarak analiz edilmiştir.

Bulgular: Cerrahi uygulanan 291 malign over tümöründen 33’ünde (%11.3) jinekolojik olmayan primer bölgelerden overe metastaz tanısı saptandı. En sık primer tümör bölgeleri sırası ile kolorektum (%45.5), mide (%15.2) ve meme (%12.1) idi. Hastaların çoğunda ameliyat öncesi serum Ca-125 düzeyleri yüksekti (%71.4); yaklaşık yarısında senkron over metastazı (%48.5); yaklaşık üçte birinde peritoneal tutulum (%36.4) ve/veya asit (%30.3) mevcuttu. Hastaların %72.0’sinde tam rezeksiyon (R0) elde edildi. Ortanca takip süresi 15.5 ay olup, 2 ila 85 ay arasında değişmektedir. Ortanca genel sağkalım 41 ay iken tahmini 18, 24 ve 36 aylık sağkalım oranları sırasıyla %60,1, %56,1 ve %50,5 idi. Yaş (>45 yıl; hazard oranı (HR): 3.199; %95 güven aralığı (CI): 0.899 - 11.380) ve asit varlığı (HR: 4.109, %95 CI: 1.436 - 11.757) sağkalımın bağımsız belirleyicileri olarak saptandı.

Sonuç: Jinekolojik olmayan primer bölgelerden kaynaklanan overin metastatik tümörlerinde, yaş ve asit varlığı prognozun ana belirleyicileri iken sitoredüktif cerrahinin sağkalım yararı gösterilememiştir.

Keywords

Over, Metastaz, Prognoz, Sağkalım

Supporting Institution

Yok

Project Number

Yok

Clinicopathological characteristics and prognosis in ovarian metastatic tumors from non-gynecologic primary sites

Abstract

Aim: To investigate clinicopathological characteristics and prognosis in ovarian metastatic tumors from non-gynecologic primary sites.

Materials and methods: This study was a retrospective trial enrolling consecutive patients with ovarian metastasis from non-gynecologic primary sites, either diagnosed synchronous or metachronously, who underwent surgery at a single institution between January 2015 and December 2021. Clinicopathological characteristics of patients were extracted from patients’ charts and electronic database; and analyzed using Cox proportional hazard models.

Results: Of the 291 malignant ovarian tumors that underwent surgery, 33 (11.3%) had a diagnosis of ovarian metastasis from non-gynecologic primary sites. The most common primary tumor sites were colorectum (45.5%), stomach (15.2%), and breast (12.1%). Most of the patients exhibited elevated preoperative serum Ca-125 levels (71.4%); roughly half of the patients had syncronous ovarian metastases (48.5%); and approximately one third had peritoneal involvement (36.4%) and/or ascites (30.3%). A complete resection (R0) was achieved in 72.0% of the patients. The median follow-up time was 15.5 months, ranging from 2 to 85 months. The median overall survival (OS) was 41 months with estimated 18-, 24- and 36-month OS rates of 60.1%, 56.1% and 50.5%, respectively. Age (>45 years; hazard ratio (HR): 3.199; 95% confidence interval (CI): 0.899 – 11.380) and presence of ascites (HR: 4.109, 95% CI: 1.436 – 11.757) were independent predictors of OS.

Conclusion: In ovarian metastatic tumors from non-gynecologic primary sites, age and the presence of ascites are the main determinants of prognosis, while no survival benefit of cytoreductive surgery was demonstrated.

Keywords

Ovarian, Metastasis, Prognosis, Survival

Project Number

Yok

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