Meme koruyucu cerrahi ve radyoterapi uygulanan T1-2NOMO meme kanseri hastalarda prognostik faktörler
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Date
2007
Authors
Çoban, Fatma Sena Kurt
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
AMAÇ: Meme koruyucu cerrahi ve radyoterapi uygulanan T1-2N0M0 meme kanserli olgularda prognostik faktörleri değerlendirmek. GEREÇ VE YÖNTEM: Uludağ Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı (AD) Muammer Ağım (MA) Radyoterapi Merkezi’nde 1995-2005 yılları arasında meme koruyucu cerrahi (MKC) sonrası radyoterapi (RT) uygulanan 198 olgu retrospektif olarak değerlendirildi. Radyoterapi 2 Gy/fraksiyon doz ile tüm memeye 46-50 Gy ve tümör yatağına 16-20 Gy boost dozu verilerek toplam 66 Gy’e tamamlandı. Olguların medyan yaşı 50 (aralık: 28-85) olup, 115’i (%58) evre I, 83’ü (%42) evre II idi. Sağkalım üzerine etkili prognostik faktörler demografik, tümörle ve tedaviyle ilgili parametreler olarak analiz edildi. İstatiksel analizler SPSS 13 paket program kullanılarak yapıldı. Sağkalım analizlerinde Kaplan-Meier Log Rank yöntemi ve sağkalım üzerinde etkili olan faktörlerin mutivaryat analizlerinde ise Cox regresyon testi kullanıldı. BULGULAR: Medyan 49 aylık (aralık: 2-137) izlem süresi içinde olguların 3’ünde (%1.5) lokal yineleme, 16’sında (%8) uzak metastaz saptanmış olup, lokal yinelemesi olan olguların hiçbirinde uzak metastaz izlenmemiştir. On olgu (%50) meme kanseri ve 10 olgu da komorbid hastalıklara bağlı olarak kaybedildi. Beş yıllık genel sağkalım (GSK) %95 ve hastalıksız sağkalım (HSK) %86 olarak bulundu. HSK üzerine etkili faktörler; yaş (p<0.001), ailede meme kanseri hikayesi (p=0.031), evre (p=0.006), tümör çapı (p=0.009), tümör volümü (p=0.004), lenfovasküler invazyon (p=0.023), ve metastaz (p<0.001) olarak belirlenirken, GSK üzerine etkili faktörler ise; yaş (p<0.001), ailede meme kanseri hikayesi (p=0.035), evre (p=0.007), tümör çapı (p=0.011), tümör volümü (p=0.046), lenfovasküler invazyon (p=0.017) ve metastaz (p<0.001) olarak bulundu. HSK ve GSK üzerinde etkili faktörlerin Cox regresyon analiziyle yapılan çok değişkenli değerlendirmesinde yaş (p<0,001) ve metastaz (p<0.001) GSK üzerinde anlamlı parametreler olarak bulundu. SONUÇ: Çalışmamızda T1-2 nod negatif meme kanserli olgularda yaş, ailede meme kanseri hikayesi, evre, tümör çapı ve volümü, lenfovasküler invazyon olması ve uzak metastaz olması önemli prognostik faktörler olarak belirlenmiştir.
PURPOSE: The aim of this study is to identify the prognostic factors after breast conserving surgery and radiotherapy in patients with T1-2N0M0 breast cancer. MATERIALS AND METHODS: In the Muammer Ağım (MA) Radiotherapy Center of Uludag University Medical Faculty Department of Radıation Oncology one hundred ninety eight patients threated with radiotherapy after breast conserving surgery during 1995-2005 were evaluated retrospectively. Radiotherapy was applied 46-50 Gy with a daily fraction dose of 2 Gy for the whole breast , 16-20 Gy boost for the tumor bed and total dose completed was 66 Gy. Median age was 50 (range: 28-85). One hundred and fifteen (58%) had stage I, 83 (42%) had stage II disease. The prognostic factors were analysed as the parameters associated with demografic, tumor and therapy. The program SPSS 13 was used for statistical analysis. The survival analysis were calculated with Kaplan-Meier Log Rank method and Cox regression models were applied to identify multivariate analysis for the factors that influence on survey. OUTCOMES: During a median follow-up duration of 49 months (range: 2137) 3 patients (1,5%) developed local recurrence and 16 patients (8%) developed distant metastasis. No metastasis was detected in patients who developed local recurrence.Ten patients (50%) had died due to breast cancer and the other 10 patients had died because of comorbid illnesses. Five-year overall survival was 95% and disease-free survival was 86%. Age (p<0.001), family history in breast cancer (p=0.031), stage (p=0.006), tumor diameter (p=0.009) , tumor volume (p=0.004), lymphovascular invasion (p=0.023) and metastasis (p<0.001) were the prognostic factors influencing disease-free survival. However, age (p<0.001), family history (p=0.035), stage (p=0.007), tumor diameter (p=0.011), tumor volume (p=0.046), lymphovascular invasion (p=0.017), and metastasis (p<0.001) were found as the prognostic factors influencing overall survival. In Cox regression model that identify multivariate analysis, age (p<0,001) and metastasis (p<0,001) were found to be the significant parameters on overall survival. CONCLUSION: In the present study which evaluated T1-2 node negative breast cancer; age, familial breast cancer history, stage, tumor diameter and volume, lymphovascular invasion and distant metastasis were found significant prognostic factors.
PURPOSE: The aim of this study is to identify the prognostic factors after breast conserving surgery and radiotherapy in patients with T1-2N0M0 breast cancer. MATERIALS AND METHODS: In the Muammer Ağım (MA) Radiotherapy Center of Uludag University Medical Faculty Department of Radıation Oncology one hundred ninety eight patients threated with radiotherapy after breast conserving surgery during 1995-2005 were evaluated retrospectively. Radiotherapy was applied 46-50 Gy with a daily fraction dose of 2 Gy for the whole breast , 16-20 Gy boost for the tumor bed and total dose completed was 66 Gy. Median age was 50 (range: 28-85). One hundred and fifteen (58%) had stage I, 83 (42%) had stage II disease. The prognostic factors were analysed as the parameters associated with demografic, tumor and therapy. The program SPSS 13 was used for statistical analysis. The survival analysis were calculated with Kaplan-Meier Log Rank method and Cox regression models were applied to identify multivariate analysis for the factors that influence on survey. OUTCOMES: During a median follow-up duration of 49 months (range: 2137) 3 patients (1,5%) developed local recurrence and 16 patients (8%) developed distant metastasis. No metastasis was detected in patients who developed local recurrence.Ten patients (50%) had died due to breast cancer and the other 10 patients had died because of comorbid illnesses. Five-year overall survival was 95% and disease-free survival was 86%. Age (p<0.001), family history in breast cancer (p=0.031), stage (p=0.006), tumor diameter (p=0.009) , tumor volume (p=0.004), lymphovascular invasion (p=0.023) and metastasis (p<0.001) were the prognostic factors influencing disease-free survival. However, age (p<0.001), family history (p=0.035), stage (p=0.007), tumor diameter (p=0.011), tumor volume (p=0.046), lymphovascular invasion (p=0.017), and metastasis (p<0.001) were found as the prognostic factors influencing overall survival. In Cox regression model that identify multivariate analysis, age (p<0,001) and metastasis (p<0,001) were found to be the significant parameters on overall survival. CONCLUSION: In the present study which evaluated T1-2 node negative breast cancer; age, familial breast cancer history, stage, tumor diameter and volume, lymphovascular invasion and distant metastasis were found significant prognostic factors.
Description
Keywords
Erken evre meme kanseri, Nod negatif, Meme koruyucu cerrahi, Prognostik faktörler, Tümör boyutu, Early stage breast cancer, Node negative, Breast conserving surgery, Prognostic factors, Tumor diameter
Citation
Çoban, F. S. K. (2007). Meme koruyucu cerrahi ve radyoterapi uygulanan T1-2NOMO meme kanseri hastalarda prognostik faktörler. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.