HER2 pozitif metastatik mide kanseri hastaların retrospektif incelenmesi
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Date
2023
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Bursa Uludağ Üniversitesi
Abstract
Mide kanseri Türkiye’de ve dünyada önemli bir mortalite nedenidir. Prognozunda etkili olduğu bilinen faktörler, hastalığının seyrinin tahmininde, tedavi modalitelerinin seçiminde kullanılmaktadır. Çalışmamızda Bursa Uludağ Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı‘na 2010-2023 yılları arasında başvurmuş, HER2-pozitif metastatik mide kanseri tanısı almış 26 hastanın klinik, histopatolojik ve laboratuvar verileri retrospektif olarak incelendi. Çalışmamızdaki 26 hastanın 7’si kadın (%26,9), 19’u erkekti (%73,1). Progresyonsuz sağ kalım süresinin (PFS) medyan değeri 9,40 ay, medyan genel sağ kalım süresi (OS) 13,36 ay bulundu. Demografik faktörlerin PFS ve OS ile ilişkisi incelendiğinde istatistiksel olarak anlamlı bir sonuç bulunamadı. Histopatolojik özelliklerin PFS ile ilişkisi araştırıldığında ise PFS ile kemik metastazı arasında anlamlı bir ilişki bulundu (p=0,007). Kemik metastazı olanların progresyon görülme sürelerinin kemik metastazı olmayanlara göre daha düşük olduğu tespit edildi. OS ile histopatolojik özellikler arasındaki ilişki incelendiğinde kemik metastazı varlığına ve metastazlı bölge sayısına göre istatistiksel olarak anlamlı ilişki bulundu (kemik metastazı için p<0,001metastazlı bölge sayısı için p=0,047). Hastaların laboratuvar verileri ile OS ve PFS karşılaştırıldığında ise sadece trombosit/lenfosit oranı (PLR) ile OS arasında sınırda anlamlı bir ilişki bulundu (p=0,05).Çalışmamızın retrospektif bir çalışma olması ve vaka sayımızın az olması çalışmamızın kısıtlılıkları arasındadır. Bu durum, bazı parametreler için yeterli hasta sayısının sağlanamamasına, istatistiksel analizlerinin yapılamamasına veya kısıtlanmasına neden olmuştur. Çalışmamızda PFS için kemik metastazı varlığı, OS için metastazlı bölge sayısı ve kemik metastazı varlığı istatistiksel olarak anlamlı yorumlanmış olup doğrulanması için daha geniş popülasyonlu ve çok merkezli çalışmalara ihtiyaç vardır.
Gastric cancer is a significant cause of mortality in Turkey and around the world. Factors known to be effective in its prognosis are used to predict the course of the disease and to choose treatment modalities. In our study, clinical, histopathological, and laboratory data of 26 patients who were admitted to Bursa Uludağ University Faculty of Medicine, Department of Medical Oncology between 2010-2023 and diagnosed with HER2-positive metastatic gastric cancer were analyzed retrospectively. Of the 26 patients in our study, 7 (26.9%) were female, and 19 (73.1%) were male. The median value of progression-free survival (PFS) was 9.40 months, and the median overall survival (OS) was 13.36 months. As a result of examining the relationship of demographic factors with PFS and OS, no statistically significant relationship was found. When the relation of histopathological features with PFS was investigated, a significant relationship was found between PFS and bone metastasis (p=0,007). The progression time of those with bone metastases is lower than those without bone metastases. When the relationship between OS and histopathological features was examined, a statistically significant relationship was found according to the presence of bone metastasis and the number of metastatic sites (p<0,001 for bone metastasis, p=0,047 for the number of metastatic sites). When the laboratory data of the patients were compared with OS and PFS, only a borderline association was found between the platelet‑to-lymphocyte ratio (PLR) and OS (p=0,05).The limitations of our study are that it was a retrospective study and the number of cases was small. This situation cause an insufficient number of patients to be provided for some parameters, and the statistical analyses not being able to be conducted or restricted. In our study, the relationship of the presence of bone metastases with PFS and OS and the relationship between OS and the number of metastatic sites were interpreted as statistically significant. Still, more multicenter studies with a larger number of participants are needed to confirm the findings.
Gastric cancer is a significant cause of mortality in Turkey and around the world. Factors known to be effective in its prognosis are used to predict the course of the disease and to choose treatment modalities. In our study, clinical, histopathological, and laboratory data of 26 patients who were admitted to Bursa Uludağ University Faculty of Medicine, Department of Medical Oncology between 2010-2023 and diagnosed with HER2-positive metastatic gastric cancer were analyzed retrospectively. Of the 26 patients in our study, 7 (26.9%) were female, and 19 (73.1%) were male. The median value of progression-free survival (PFS) was 9.40 months, and the median overall survival (OS) was 13.36 months. As a result of examining the relationship of demographic factors with PFS and OS, no statistically significant relationship was found. When the relation of histopathological features with PFS was investigated, a significant relationship was found between PFS and bone metastasis (p=0,007). The progression time of those with bone metastases is lower than those without bone metastases. When the relationship between OS and histopathological features was examined, a statistically significant relationship was found according to the presence of bone metastasis and the number of metastatic sites (p<0,001 for bone metastasis, p=0,047 for the number of metastatic sites). When the laboratory data of the patients were compared with OS and PFS, only a borderline association was found between the platelet‑to-lymphocyte ratio (PLR) and OS (p=0,05).The limitations of our study are that it was a retrospective study and the number of cases was small. This situation cause an insufficient number of patients to be provided for some parameters, and the statistical analyses not being able to be conducted or restricted. In our study, the relationship of the presence of bone metastases with PFS and OS and the relationship between OS and the number of metastatic sites were interpreted as statistically significant. Still, more multicenter studies with a larger number of participants are needed to confirm the findings.
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Keywords
Metastatik mide kanseri, HER2, Trastuzumab, Sağ kalım, Metastatic gastric cancer, Survival
Citation
Sülün, G. İ. (2023). HER2 pozitif metastatik mide kanseri hastaların retrospektif incelenmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.