Öz
Aim: Aim of this study is to evaluate epidemiologic features and survival outcomes of 2647 patients treated with the diagnosis of cervical cancer (CC) in Ege University Hospital (EUH) between 1992-2017 and compare them with the literature.
Materials and Methods: Data recorded to CANREG-4 program in EUH between 1992-2017 by EU Fight Against Cancer Research and Application Center (EUKAM) were grouped according to WHO and SEER systems. For statistical analysis, Chi-square method and general linear modeling and Kaplan-Meier analysis were performed. In Kaplan-Meier analysis, Log Rank (Mantel-Cox), Breslow (Generalized Wilcxon) and Tarone-Ware methods were used. p<0.05 was accepted as significant.
Results: Cervical cancer consisted 31.8% of gynecologic malignancies. It was mostly seen at the ages between 40-49. Most common histologic subtype was squamous cell cancer; it was followed by adenocarcinoma of the cervix. Patients were mostly diagnosed at the local advanced stage (47.2%). Median survival was 120 months. 5 year overall survival rate was 70.4% and 10 year overall survival rate was 59.4%.
Conclusion: Cervical cancer is an important type of gynecologic malignancies. When 25 years data of our hospital was evaluated, demographic and histolopathologic data were found similar with the literature, additionally survival was found similar and even better in metastatic disease according to developed countries.
Anahtar Kelimeler
Cervical cancer Epidemiology Incidence Mortality Overall Survival
Kaynakça
- Globocan 2018. http://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019; 69 (1): 7-34.
- Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999; 189 (1):12-9.
- International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int J Cancer. 2007; 120 (4): 885-91.
- Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007; 370 (9590): 890-907.
- Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev. 2013; 2:35.
- Dickinson JA, Stankiewicz A, Popadiuk C, Pogany L, Onysko J, Miller AB. Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC Public Health. 2012; 12: 992.
- Wright TC Jr, Stoler MH, Behrens CM, Apple R, Derion T, Wright TL. The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol. 2012; 206 (1): 46.e1-46.e11.
- Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, SemraTuran H, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women. Int J Cancer. 2018 May 1; 142 (9): 1952-8.
- Weir HK, Thun MJ, Hankey BF, Ries LA, Howe HL, Wingo PA, Jemal A, Ward E, Anderson RN, Edwards BK. Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst. 2003 Sep 3; 95 (17): 1276-99.
- Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018 Oct; 143 Suppl 2: 22-36.
- Survival rates for cervical cancer. American Cancer Society. https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html.
Öz
Amaç: Ege Üniversitesi Hastanesinde 1992-2017 arası kanser tanı ve tedavisi yapılan 2647 serviks uteri kanserinin epidemiyolojik ve sağ kalım özelliklerini analiz etmek ve sonuçları literatürle karşılaştırmaktır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan serviks uteri kanseri verileri CANREG özel bilgisayar programına kaydedilmiş, DSÖ ve SEER sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Ki-kare, General Linear Model, Kaplan Meier sağ kalım analizleri uygulanmıştır. Kaplan Meier Sağ kalım analizinde LogRank (Mantel-Cox), Breslow (Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p<0.05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Serviks uteri kanserinin jinekolojik kanserler arasında görülme oranı %31,8 olarak saptanmıştır. En sık görüldüğü yaş grubu 40-49’dur. En sık görülen histolojik alt tip, yassı hücreli kanser olup, onu adenokanserler takip etmiştir. Hastalar en sık lokal ileri evrede tanı almaktadır (%47,2). Ortalama sağ kalım süresi 120 ay olarak saptanmıştır. Beş yılık genel sağ kalım oranı %70,4, 10 yıllık genel sağ kalım oranı ise %59,4 olarak bulunmuştur.
Sonuç: Serviks uteri kanseri, jinekolojik kanserler arasında önemli bir yer tutmaktadır. Hastanemizin 2beş yıllık kayıtları değerlendirildiğinde, demografik verilerin ve histopatolojik bulguların literatür ile uyumlu olduğu, sağ kalım sürelerinin ise gelişmiş ülkeler ile benzer hatta ileri evre olgularda daha iyi olduğu görülmektedir.
Anahtar Kelimeler
Serviks uteri kanseri epidemiyoloji insidans mortalite genel sağ kalım
Kaynakça
- Globocan 2018. http://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019; 69 (1): 7-34.
- Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999; 189 (1):12-9.
- International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int J Cancer. 2007; 120 (4): 885-91.
- Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007; 370 (9590): 890-907.
- Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev. 2013; 2:35.
- Dickinson JA, Stankiewicz A, Popadiuk C, Pogany L, Onysko J, Miller AB. Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC Public Health. 2012; 12: 992.
- Wright TC Jr, Stoler MH, Behrens CM, Apple R, Derion T, Wright TL. The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol. 2012; 206 (1): 46.e1-46.e11.
- Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, SemraTuran H, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women. Int J Cancer. 2018 May 1; 142 (9): 1952-8.
- Weir HK, Thun MJ, Hankey BF, Ries LA, Howe HL, Wingo PA, Jemal A, Ward E, Anderson RN, Edwards BK. Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst. 2003 Sep 3; 95 (17): 1276-99.
- Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018 Oct; 143 Suppl 2: 22-36.
- Survival rates for cervical cancer. American Cancer Society. https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 15 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 |