YÜKSEK RİSKLİ VE DÜŞÜK RİSKLİ ENDOMETRİUM KANSERLERİ HASTALARDA İLERİ YAŞ KÖTÜ PROGNOSTİK BİR FAKTÖR MÜDÜR?

Is Advanced Age a Poor Prognostic Factor In High Risk and Low Risk Endometrial Cancer Patients?

Muzaffer SANCI, Orhan TEMEL, Mustafa BAĞCI, Selçuk ERKILINÇ, Tuğba KARADENİZ, Mehmet GÖKÇÜ, Ulaş SOLMAZ

Özet

Amaç: Yüksek riskli ve düşük riskli endometrium kanserinde ileri yaşın sağkalım üzerine etkisini araştırmak Metod: 1995-2015 yılları arasında düşük riskli 759, yüksek riskli 139 endometrium kanseri hastası çalışmaya dahil edildi. Demografik veriler, cerrahi tedavi verileri retrospektif olarak değerlendirildi. Yaşın sağkalım üzerine etkisinin araştırılması için Univariate ve multivariate regresyon analizi yapıldı. Bulgular: Düşük riskli ve yaşlı hastalarda genç hastalarla karşılaştırıldığında dış myometrial invazyon, radyoterapi, lefovasküler invazyon anlamlı olarak daha fazlaydı. Yüksek riskli yaşlı hastlarada sadece radyoterapi oranı yüksek bulundu. Yüksek riskli düşük riskli hastalarda ileri yaş total sağkalım için bağımsız bir risk faktörü olarak bulundu Sonuç: Hem yüksek riskli hem de düşük riskli endometrium kanserli hastalarda ileri yaş olumsuz prognostik bir faktör olarak bulunmuştur.

Abstract

Objective: To evaluate the effect of advanced age on high risk and low endometrial cancerpatients.Methods: A total of 759 patients with type I endometrial cancer and 139 patients with type IIendometrial cancer between January 1995 to December 2015 were included to the study. Highrisk and low risk patients were devided into two groups according to age. Demographic data,surgical treatment, adjuvant treatment and survival characteristics were compared betweenage groups in high risk and low risk patients. To detect the independent hazard of the variableson survival univariate and multivariate Cox regression analysis was performed.Results: Outer ½ myometrial invasion, adjuvant radiotherapy, LVSI, tumor diameter weresignificantly higher in advanced age groups in low risk patients. Admission of adjuvantradiotherapy was the only parameter that differed between older and younger age groups inhigh risk patients. Both disease free survival and overall survival were higher in younger lowrisk patients. Overall survival was longer in high risk and younger age patients, but disesasefree survival was similar. Multivariate Cox-regression analysis revealed that advanced age wasa significant independent hazard for overall survival both in high risk and low risk endometrialcancer patients (HR:1.94, 95% CI:1,0-3,4).Conclusion: Our study suggested that advanced age was a poor prognostic factor both for lowrisk and high risk endometrial cancer patients.