40 yaş ve altı meme kanserli kadınlarda etyolojik, prognostik faktörlerin değerlendirilmesi ve sağkalım analizi
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Date
2017
Authors
Türk, Ali
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada 40 yaş ve altında tanı almış meme kanserli kadın olgularda etyolojik, prognostik faktörler ve bunların genel sağkalım (GSK), hastalıksız sağkalım (HSK) üzerine olan etkisinin irdelenmesi amaçlanmıştır. 01/01/2005-01/01/2015 arasında başvuran 40 yaş ve altı 222 olgu retrospektif olarak incelendi. Olguların etyolojik, prognostik faktörleri, uygulanan tedaviler ve takip verilerinin analizi tek değişkenli ve çok değişkenli olarak analiz edildi. Olguların ortalama yaşı 35,1'dir (17-40). Ortalama GSK 117,91 (±3,34) ay, ortalama HSK 62,79 (±3,22) ay olarak bulundu. Tanıda 18 (%8,1) olgu metastatikti, takiplerde 32 (14,4) olguda metastaz gelişti, metastatik olgu sayısı 50'ye (%22,5) ulaştı. 22 (%9,9) olguda nüks gelişti. 12 (%5,4) olguda nüks ve metastaz gelişti. 2'sinde karşı memede olmak üzere 13 (%5,9) olguda ikinci primer malignite gelişti. 28 olgu yaşamını yitirdi. Yapılan tek değişkenli ve çok değişkenli analizde etyolojik faktörlerin GSK ve HSK üzerinde anlamlı fark oluşturmadığı saptandı. Prognostik faktörlerden bilateralite, patolojik tip, tümör boyutu (T), metastazlı lenf nodu sayısı, N evresi (N), uzak metastaz (M), evre, tanıdaki metastaz bölgesi, klinik olarak saptanan metastazlı lenf nodu bölgesinin tek değişkenli analizde GSK ve HSK üzerinde etkili olduğu saptandı. Ek olarak multisentrik tümör varlığının, perinöral invazyonun, ekstra kapsüler yayılımın HSK üzerine etkili olduğu saptandı. Çok değişkenli analizde sadece evrenin GSK üzerine etkili olduğu; HSK üzerine ise evrenin ve N evresinin, etkili olduğu saptandı (p<0,05). İrdelenen diğer faktörlerin GSK ve HSK üzerine etkisinin olmadığı saptanmıştır. Genç olgular, meme kanserli olgular içerisinde ayrı bir yere sahiptir. Genç olgularda tedavi kararları prognostik faktörlere göre alınmalıdır.
In this study, it was aimed to investigate the etiologic and prognostic factors and the effect of these on overall survival (OS) and disease free survival (DFS) in women 40 years aged and younger with breast cancer. 222 patients aged 40 years and younger who applied between 01/01/2005-01/01/2015 was retrospectively reviewed. The etiologic, prognostic factors of the cases, the data of the treatments and the follow-up data were analyzed as univariate and multivariate. The mean age of the cases is 35,1 (17-40). The mean OS was 117,91 (±3,34) months and the average DFS was 62,79 (±3,34) months. 18 (8,1%) cases were diagnosed as metastatic, 32 (14,4) cases had metastasis, and the number of metastatic cases reached 50 (22,5%). Recurrence has occurred in 22 (%9,9) cases. Recurrence and metastasis developed in 12 (%5,4) patiens. Secondary primer malignancy developed in 13 (5.9%) cases, 2 of them in the opposite breast. 28 cases lost their lives. It was determined that the etiologic factors did not make a significant difference on OS and DFS, in the univariate and multivariate analysis. Prognostic factors include bilaterality, pathologic type, tumor size (T), number of metastatic lymph nodes, N stage (N), distant metastasis (M), stage, metastasis site at diagnosis, clinically detected metastatic lymph node area were found effective on OS and DFS in univariate analysis. In addition, the presence of multicentric tumors, extra capsular invasion and perineural invasion, found effective on DFS. In the multivariate analysis, only the stage was found effective on GSK; whereas the stage and lymph node (N) were found effective on DFS (p<0,05). Other factors that were examined not found effective on OS and DFS. Young cases have a separate area within breast cancer cases. In young cases treatment decisions should be taken according to prognostic factors.
In this study, it was aimed to investigate the etiologic and prognostic factors and the effect of these on overall survival (OS) and disease free survival (DFS) in women 40 years aged and younger with breast cancer. 222 patients aged 40 years and younger who applied between 01/01/2005-01/01/2015 was retrospectively reviewed. The etiologic, prognostic factors of the cases, the data of the treatments and the follow-up data were analyzed as univariate and multivariate. The mean age of the cases is 35,1 (17-40). The mean OS was 117,91 (±3,34) months and the average DFS was 62,79 (±3,34) months. 18 (8,1%) cases were diagnosed as metastatic, 32 (14,4) cases had metastasis, and the number of metastatic cases reached 50 (22,5%). Recurrence has occurred in 22 (%9,9) cases. Recurrence and metastasis developed in 12 (%5,4) patiens. Secondary primer malignancy developed in 13 (5.9%) cases, 2 of them in the opposite breast. 28 cases lost their lives. It was determined that the etiologic factors did not make a significant difference on OS and DFS, in the univariate and multivariate analysis. Prognostic factors include bilaterality, pathologic type, tumor size (T), number of metastatic lymph nodes, N stage (N), distant metastasis (M), stage, metastasis site at diagnosis, clinically detected metastatic lymph node area were found effective on OS and DFS in univariate analysis. In addition, the presence of multicentric tumors, extra capsular invasion and perineural invasion, found effective on DFS. In the multivariate analysis, only the stage was found effective on GSK; whereas the stage and lymph node (N) were found effective on DFS (p<0,05). Other factors that were examined not found effective on OS and DFS. Young cases have a separate area within breast cancer cases. In young cases treatment decisions should be taken according to prognostic factors.
Description
Keywords
Genç meme kanseri, Etyolojik faktörler, Prognostik faktörler, Radyoterapi, Sağkalım, Young breast cancer, Etiologic factors, Prognostic factors, Radiotheraphy, Survival
Citation
Türk, A. (2017). 40 yaş ve altı meme kanserli kadınlarda etyolojik, prognostik faktörlerin değerlendirilmesi ve sağkalım analizi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.