Baş boyun kanserli hastalarda tedavi sonuçları ve prognostik faktörler

Abstract

Amaç. Merkezimizde takip ve tedavi edilen baş boyun kanseri hastalarında klinikopatolojik özelliklerin, tedavi sonuçlarının ve sağkalımı etkileyen prognostik faktörlerin incelenmesi amaçlanmıştır. Yöntem. 2007-2010 tarihleri arasında merkezimize başvuran ve baş boyun kanseri tanısı ile izlenmekte olan hastalara ait demografik, klinik ve histopatolojik veriler hasta dosya ve hastane kayıtları incelenerek elde edildi. Bulgular. Seksen iki hastaya ait veriler analiz edildi. 72 erkek (%88) ve 10 kadın (%12) hasta mevcuttu. Hastaların ortanca yaşı 57 (20-80) idi. En genç hastalar nazofarenks, parahipofarenks ve paranazal sinüs tümörü olan hastalardı. En yaygın malignensi 37 hastada (%45) bulunan larenks kanseri idi. Elli beş hasta (%67) Eastern Cooperative Oncology Group 1 idi. En sık evre 51 hasta (%62) ile lokal ileri evre idi. Tanı anında 60 (%75) hastada anemi, 30 (%60) hastada C- reaktif protein yüksekliği, 72 (%89) hastada kilo kaybı tespit edildi. Yassı hücreli karsinom 69 (%84) hasta ile en sık izlenen histopatolojik tip idi. On yedi (%47) hastada perinöral invazyon, 17 (%47) hastada lenfovasküler invazyon, 12 (%32) hastada ekstrakapsüler invazyon tespit edildi. Hastalar arasında en sık izlenen grade 34 (%42) hasta ile grade II idi. Tüm hastalar için ortanca sağkalım 34 aydı. İki yıllık genel sağkalım oranı erken evre (I-II) hastalarda %75, lokal ileri hastalarda (III-IVA ve B) %51 iken, metastatik hastalık varlığında ise ortanca sağkalım 10 ay idi. Eşlik eden hipertansiyon varlığı, performans durumu, kanserin lokalizasyonu ve evresi, T ve N evresi, radyoterapiye ara verilmesi, C- reaktif protein düzeyi ve anemi sağkalımı belirleyen faktörler idi. Sonuç. Hipertansiyon varlığı, performans durumu, kanserin lokalizasyon ve evresi, T ve N evresi, radyoterapiye ara verilmesi, C- reaktif protein düzeyi ve anemi baş boyun kanserli hastalarda sağkalımı etkileyen prognostik faktörler olarak belirlendi.

Aim. Our aim was to investigate the clinicopathological features, the treatment outcome and the prognostic factors affecting survival in patients with head and neck cancer followed and treated in our center. Methods. The demographic, clinical and the histopathological data of the patients who were admitted to our center between 2007 and 2010 with a diagnosis of head and neck cancer were examined using the medical records. Results. The data from 82 patients were analyzed. There were 72 men (88%) and 10 women (12%). The median age of the patients was 57 (20-80) years. The youngest patients had nasopharyngeal, parahypopharyngeal and paranasal sinus tumors. The most commonly encountered malignancy was the laryngeal cancer, which was found in 37 patients (45%). Fifty-five patients (67%) were Eastern Cooperative Oncology Group 1. The most common grade was the locally advanced stage with 51 patients (62%). At time of the diagnosis, 60 (75%) patients had anemia, 30 (60%) patients had an elevated C-reactive protein, and 72 (89%) patients had weight loss. Squamous cell carcinoma, which was seen in 69 (84%) patients, was the most common histological type. Seventeen (47%) patients had perineural invasion, 17 (47%) patients had lymphovascular invasion, and 12 (32%) patients had extracapsular invasion. Among the patients, the most common grade was grade II, which was found in 34 (42%) patients. The overall Sivas Numune Hastanesi, median survival was 34 months. The 2-year survival rate was 75% for the patients with early-stage (I-II) cancer and 51% for the patients with locally advanced (III-IVA and B) cancer, the median survival was 10 months in the presence of metastatic disease. The presence of hypertension comorbidity, performance status, location and stage of the cancer, T and N stage, interruption of radiation therapy, C-reactive protein levels, and anemia were the factors that determined survival. Conclusion. The presence of hypertension, performance status, location and stage of the cancer, T and N stage, interruption of radiation therapy, C-reactive protein levels, and anemia were identified as prognostic factors affecting survival in patients with head and neck cancers.