Abstract
Özet
Giriş: Cerrahi olarak orşiektomi yapılmış
erken evre seminom hastalarında mükemmel bir prognoz gözlenir. Seminom
hastaları metastatik evrede olsa bile yaklaşık olarak %50 kür şansı mevcuttur.
Bu nedenle özellikle risk faktörü taşımayan erken evre seminom hastaları aktif
izlem ile takip edilebilir. Aktif izlemdeki temel amaç; cerrahi orşiektomi
sonrası hiçbir şekilde nüks etmeyecek olan %85 hastayı doğru olarak tespit
etmek ve o hastaları gereksiz tedaviden ve kemoterapinin yan etkilerinden
korumaktır. Biz bu çalışmamızda seminom hastalarında rekürrens riskini arttırabilecek
faktörleri araştırdık.
Materyal-Metod:
Tek merkezli retrospektif olan bu çalışmaya erken evre seminom hastaları dahil
edildi. Çalışmaya 18 yaş üstü olan çalışmaya dahil eilme kriterlerine uygun 70
hasta alındı. Çalışmadaki amacımız erken evre seminom hastalarında prognoz
üzerinde etkili olan faktörler, nüksü gösteren bir prediktif değer olup
olmadığının araştırılması olarak belirlendi. Hasta sayısının az olması nedeni
ile ölüm ve nüks için regresyon modeli oluşturulamadı. Ancak hipotez testi olarak
univariable Cox regresyon ve Logrank testi uygulandı.
Bulgular:.
Hastaların median yaşı 35,7 (27,24-38,09) yıl idi. Hastaların 61’i (%87,1) evre
I ve 9’u (%12,9) evre II hastalığa sahip idi. Yapılan istatistiksel analizde
hastalığın evresi ile rekürrens arasında anlamlı ilişki mevcut idi. Toplamda
nüks eden 10 yastanın 4’ü (%40) evre II’de olup bu durum istatistiksel olarak
anlamlı idi (p:0.019) (Şekil-I). Diğer parametreler ve rekürrens arasında
anlamlı ilişki izlenmedi.
Tartışma ve
sonuç: Lenfovasküler
invazyon, spermatik kord tutulumu, tunika albuginea tutulumu ve rete testis
tutulumu gibi faktörlerin rekürrens riski ile ilişkisi izlenmezken, evrenin
rekürrens riski üzerinde etkisi olduğunu gözledik (p=0,019).
Keywords
References
- 1- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69:7.
- 2- Groll RJ, Warde P, Jewett MA. A comprehensive systematic review of testicular germ cell tumor surveillance. Crit Rev Oncol Hematol 2007; 64:182.
- 3- Warde P, Gospodarowicz M. Evolving concepts in stage I seminoma. BJU Int 2009; 104:1357.
- 4- http://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf (Accessed on February 11, 2015).
- 5- Stenning S, Oliver T, Mead B, Gabe R. Carboplatin in clinical stage I seminoma: a valuable option for patient management. J Clin Oncol 2011; 29:4210.
- 6- Oliver RT, Mead GM, Rustin GJ, et al. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol 2011; 29:957.
- 7- Einhorn LH. Treatment of testicular cancer: a new and improved model. J Clin Oncol 1990; 8:1777.
- 8- International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15:594.
- 9- International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15:594.
- 10- Feldman DR, Bosl GJ, Sheinfeld J, Motzer RJ. Medical treatment of advanced testicular cancer. JAMA 2008; 299:672.
- 11- Birch R, Williams S, Cone A, et al. Prognostic factors for favorable outcome in disseminated germ cell tumors. J Clin Oncol 1986; 4:400.
Abstract
Summary
Introduction: An excellent prognosis is observed in early stage
seminoma patients who underwent orchiectomy. Seminoma patients have
approximately 50% chance of cure even if they are in metastatic stage.
Therefore, especially early stage seminoma patients without risk factors can be
followed up with active surveillance. The main purpose of active
surveillance is to accurately detect 85%
of patients who will not relapse after surgical orchiectomy and to protect them
from unnecessary treatment and side effects of chemotherapy. In this study, we
investigated the factors that may increase the risk of recurrence in seminoma
patients.
Material-Method: Early stage
seminoma patients were included in this single-center retrospective study. 70
patients who were over 18 years of age were included in the study. The aim of
this study was to determine whether there is a predictive value of recurrence
in patients with early stage seminoma. Regression model for death and
recurrence could not be established because of the small number of patients.
However, univariable Cox regression and Logrank test were used as hypothesis
test.
Results: The median age
of the patients was 35.7 (27.24-38.09) years. 61 patients (87.1%) had stage I
disease and 9 patients (12.9%) had stage II disease. In statistical analysis,
there was a significant relationship between the stage of the disease and
recurrence. In total, 4 (40%) of the 10 relapsed ages were in stage II, and
this was statistically significant (p: 0.019) (Figure-I). There was no
significant relationship between other parameters and recurrence.
Discussion and
conclusion: While there was no relationship between recurrence
risk and lymphovascular invasion, spermatic cord involvement, tunica albuginea
involvement and rete testis involvement (p = 0.019),we saw the effect of stage
on reccurence risk(p=0,019)
Keywords
References
- 1- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69:7.
- 2- Groll RJ, Warde P, Jewett MA. A comprehensive systematic review of testicular germ cell tumor surveillance. Crit Rev Oncol Hematol 2007; 64:182.
- 3- Warde P, Gospodarowicz M. Evolving concepts in stage I seminoma. BJU Int 2009; 104:1357.
- 4- http://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf (Accessed on February 11, 2015).
- 5- Stenning S, Oliver T, Mead B, Gabe R. Carboplatin in clinical stage I seminoma: a valuable option for patient management. J Clin Oncol 2011; 29:4210.
- 6- Oliver RT, Mead GM, Rustin GJ, et al. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol 2011; 29:957.
- 7- Einhorn LH. Treatment of testicular cancer: a new and improved model. J Clin Oncol 1990; 8:1777.
- 8- International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15:594.
- 9- International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15:594.
- 10- Feldman DR, Bosl GJ, Sheinfeld J, Motzer RJ. Medical treatment of advanced testicular cancer. JAMA 2008; 299:672.
- 11- Birch R, Williams S, Cone A, et al. Prognostic factors for favorable outcome in disseminated germ cell tumors. J Clin Oncol 1986; 4:400.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | September 30, 2020 |
| Submission Date | November 22, 2019 |
| Acceptance Date | October 6, 2020 |
| Published in Issue | Year 2020 Volume: 6 Issue: 3 |
