Mide kanserinde prognostik faktörler
Date
2005-02-20
Authors
Bağcıvan, Erol
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Mide kanseri nedeniyle ameliyat ettiğimiz hastalarda prognostik faktörlerin belirlenmesi. Gereç ve Yöntem: Ocak 1990-Aralık 2000 yılları arasında mide kanseri nedeniyle opere edilen 363 hastadan 15’in üzerinde lenf bezi çıkarılan, küratif rezeksiyon uygulanan 81 hastanın kayıtları retrospektif olarak incelendi.Yaş, cinsiyet, başvuru semptomları, uygulanan ameliyat şekli, ameliyata eklenen diğer organ rezeksiyonları, postoperatif komplikasyonlar, tümör yerleşim yeri, tümör boyutu, tümör makroskopik tipi, tümör histolojik tipi, invazyon derinliği, toplam çıkarılan lenf nodu sayıları, metastatik lenf nodu sayıları sınıflamasının prognostik faktör olarak sağkalıma etkisine bakıldı. Bulgular: Hastaların 51’i erkek, 30’u kadın ve yaş ortalamaları 57.8 (24-77) idi. Hastaların verileri univaryans analizle incelendiğinde; proksimal lokalizasyonu ve diffüz yayılım(p=0.005), tümör boyutunun 10 cm’den büyük olması (p=0.002), tümör makroskopik tipi(borrman tip IV) (p=0.008), invazyon derinliği (p=0.024), metastatik lenf nodu sayısının 6’dan büyük olması (p=0.026) ve TNM sınıflamasının(evre IIIB) (p=0.035) sağkalıma etkisi olduğu görüldü. Bu faktörler multivaryans Cox regresyon analiziyle incelendiğinde metastatik lenf nodu sayısı, metastatik lenf nodunun toplam çıkarılan lenf noduna oranının ve TNM sınıflamasının bağımsız prognostik faktörler olduğu saptandı. Sonuç: Çalışmamızda metastatik lenf nodu sayısı, metastatik lenf nodu sayısının çıkarılan toplam lenf nodu sayısına oranı ve TNM sınıflaması bağımsız prognostik faktörler olarak bulunmuştur. Ancak duvar invazyonu ve lenfadenektominin sağkalıma etkisini daha net ortaya koyabilmemiz için vaka serimizin ve erken evre hastalarımızın sayısının artmasına ve cerrahi tekniğin standardizasyonuna ihtiyaç vardır.
Aim: To identify the prognostic factors of the gastric cancer cases that had been operated in our department. Materials and Method: The record of 81 patients out of 363 gastric cancer patients, who had been performed the curative resection between January 1990 - December.2000, were retrospectively reviewed. Age, gender, initial symptoms, type of surgery, additive organ resections, postoperative complications, tumor lacalization, tumor size, macroscopic type of the tumor, tumor histologic type, depth of invasion, number of dissected lymph nodes, number of metastatic lymph nodes and the effects of prognostic factors on survival were investigated. Results: Of the 81 patients, 51 were men and 30 were women and the mean age was 57.8 (24-77) years. Age had no significant effect on survival. The univariant analysis of the examined factors showed that;proximal location and diffuse involvement(p=0.005), tumor size larger than 10 cm (p=0.002), macroscopic type of the tumor(bormann type IV) (p=0.008), depth of invasion (p=0.024), number of metastatic lymph nodes larger than 6 (p=0.026), TNM classification(stage IIIB) (p=0.035) were the factors affecting survival. Multivariant Cox regression analysis revealed that number of metastatic lymph nodes, the ratio of the metastatic nodes to the total number of nodes, TNM were independent predictors of survival. Conclusion: In this study, number of metastatic lymph nodes, the ratio of the metastatic nodes to the total number of nodes, TNM were found as independent predictors of survival. However, our case number was not enough make such a definite interpretation about the effect of the gastric wall invasion and lymphadenectomy on survival, Thefefore, the number of the early cases should incerase, and also the surgical procedure should be standardized.
Aim: To identify the prognostic factors of the gastric cancer cases that had been operated in our department. Materials and Method: The record of 81 patients out of 363 gastric cancer patients, who had been performed the curative resection between January 1990 - December.2000, were retrospectively reviewed. Age, gender, initial symptoms, type of surgery, additive organ resections, postoperative complications, tumor lacalization, tumor size, macroscopic type of the tumor, tumor histologic type, depth of invasion, number of dissected lymph nodes, number of metastatic lymph nodes and the effects of prognostic factors on survival were investigated. Results: Of the 81 patients, 51 were men and 30 were women and the mean age was 57.8 (24-77) years. Age had no significant effect on survival. The univariant analysis of the examined factors showed that;proximal location and diffuse involvement(p=0.005), tumor size larger than 10 cm (p=0.002), macroscopic type of the tumor(bormann type IV) (p=0.008), depth of invasion (p=0.024), number of metastatic lymph nodes larger than 6 (p=0.026), TNM classification(stage IIIB) (p=0.035) were the factors affecting survival. Multivariant Cox regression analysis revealed that number of metastatic lymph nodes, the ratio of the metastatic nodes to the total number of nodes, TNM were independent predictors of survival. Conclusion: In this study, number of metastatic lymph nodes, the ratio of the metastatic nodes to the total number of nodes, TNM were found as independent predictors of survival. However, our case number was not enough make such a definite interpretation about the effect of the gastric wall invasion and lymphadenectomy on survival, Thefefore, the number of the early cases should incerase, and also the surgical procedure should be standardized.
Description
Keywords
Mide kanseri, Prognostik faktörler, Lenf nodu metastazı, Gastric carcinoma, Prognostic factors, Iymph node metastasis
Citation
Akyağcı, S. B. vd. (2005). ''Mide kanserinde prognostik faktörler''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 31(2), 113-118.