Ege Ünı̇versı̇tesı̇ hastanesı̇ veri tabanındaki mide kanserlerinin epidemiyolojisi ve sağkalım özellikleri
Öz
Amaç: Bu çalışmada mide kanserinin (MK) epidemiyolojik ve genel sağkalım (GSK) özelliklerinin
araştırılması amaçlanmıştır.
Gereç Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezine (EÜKAM) 1992-
2017 yıllarında kayıtlı Ege Üniversitesi Tıp Fakültesi Hastanesi kanser verileri retrospektif olarak
taranmıştır. CAN-REG-4 bilgisayar programına kayıtlı veriler, Dünya Sağlık Örgütü ve Surveillance,
Epidemiology, and End Results sistemlerinde gruplanarak analizler yapılmıştır. İstatistik analizlerde ki-
kare, General Linear Model (GLM), Kaplan Meier sağkalım analizleri uygulanmıştır. Etik kurul onayı
alınmıştır.
Bulgular: EÜKAM veri tabanına kayıtlı toplam 117.139 kanserden 4.212’si (%3,6) MK’dir.
Gastrointestinal sistem kanserler içinde kolorektal kanserlerden sonra ikinci sıklıkta MK (%21,6) yer
almıştır. Olguların 2.692’si (%63,9) erkek, 1.520’si (%36,1) kadındır, arasındaki fark istatistiksel olarak
anlamlıdır (p<0,0001). Erkek/kadın oranı 1,8’dir. MK en sık 60-69 yaşlarda (%28,9) görülmüştür. En
sık tümör yerleşimi korpusdur (%31,2), bunu antrum ve kardia izlemektedir. Distal (kardia dışı)
tümörler, proksimal (kardia) tümörlerine göre yaklaşık 2,5 kat daha fazladır. Adenokarsinom en sık
(%73,6) görülen histolojik alt tiptir. MK, erkeklerde kadınlara göre daha geç evrelerde saptanmış olup,
fark istatistiksel olarak anlamlı bulunmuştur (p<0,0001). Tanı anında olgularının çoğu lokal ileri evre ve
metastatik evrede bulunmuştur. Veri toplanan son 25 yıl içinde MK olgularında sayısal olarak doğrusal
artış saptanmıştır (GLM:F=15,9;p<0,0001). MK’de medyan sağkalım 16 aydır. Beş-yıllık sağkalım
%28,1 saptanmıştır, erkeklerde %25,2 kadınlarda %32’dir, kadınlarda istatistiksel olarak anlamlı
yüksektir (p<0,0001). Adenokarsinomlar 5-yıllık %22,1 GSK oranı ile en kötü prognozu
göstermektedir. Diffüz tip adenokarsinomlarda prognoz, intestinal tipe göre daha kötüdür (p=0,020).
En iyi sağkalım oranları beklendiği gibi erken evrededir. Lokalize dönemde tanı konanlarda 5-yıllık
GSK %61,8 iken, lokal ileri evrede %32,4 e düşmektedir (p<0,0001).
Sonuç: Son 25 yıldaki verilerimizin analizinde yıllar içindeki olgu sayısında doğrusal bir artış
görülmüştür. MK erkeklerde ve 60-69 yaş arasında daha sıktır. 5-yıllık sağkalım kadınlarda erkeklere
göre daha yüksektir. MK evresi prognozda en önemli parametredir.
Anahtar Kelimeler
Kaynakça
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424.
- Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC Cancer Base No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, giriş tarihi: 15.07.2020.
- Yusefi AR, Bagheri Lankarani K, Bastani P, Radinmanesh M, Kavosi Z. Risk Factors for Gastric Cancer: A Systematic Review. Asian Pac J Cancer Prev 2018;19(3):591-603.
- De Angelis R, Sant M, Coleman MP et al. Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE--5-a population-based study. Lancet Oncol 2014;15(1):23-34.
- Lui FH, Tuan B, Swenson SL, Wong RJ. Ethnic disparities in gastric cancer incidence and survival in the USA: an updated analysis of 1992-2009 SEER data. Dig Dis Sci 2014 Dec; 59(12):3027-34.
- Bosman FT, Carneiro F, Hruban RH et al eds. WHO classification of tumours of the digestive system, vol. 3. 4th ed Lyon: International Agency for Research on Cancer, 2010.
- Lauren P. The Two Histological Main Types Of Gastric Carcinoma: Diffuse And So-Called Intestinal-Type Carcinoma. An Attempt at a Histo-Clinical Classification. Acta Pathol Microbiol Scand 1965;64:31-49.
- Haydaroğlu A, Sert F, Caner A. Ege Üniversitesi Hastanesi veri tabanındaki kanser olgularının epidemiyolojik ve genel sağ kalım özellikler. Ege Tıp Dergisi 2019;58 Ek sayı/ Supplement 1-9.
- TC Sağlık Bakanlığı Kanser İstatistikleri. 2016 Kanser İstatistikleri. Erişim: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/Trkiye_Kanser_statistikleri_2016.pdf (giriş tarihi:15 Temmuz 2020).
- Yalçın B, Zengin N, Aydın F et al. The clinical and pathological features of patients with gastric cancer in Turkey: A Turkish Oncology Group Study. Turkish Journal of Cancer 2006;36(3):108-115.
- Bor S, Vardar R, Ormeci N et al. Prevalence patterns of gastric cancers in Turkey: model of a developing country with high occurrence of Helicobacter pylori. J Gastroenterol Hepatol 2007 Dec; 22(12):2242-5.
- Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.
- Tural D, Selçukbiricik F, Akar E, Serdengeçti S, Büyükünal E. Gastric cancer: A case study in Turkey. J Can Res Ther 2013;9(4):644-8.
- Kaneko S, Yoshimura T. Time trend analysis of gastric cancer incidence in Japan by histological types, 1975- 1989. Br J Cancer 2001;84(3):400-5.
- Schwartz GK. Invasion and metastases in gastric cancer: in vitro and in vivo models with clinical correlations. Semin Oncol 1996;23(3):316-24.
- Polkowski W, van Sandick JW, Offerhaus GJ, et al. Prognostic value of Laurén classification and c-erbB-2 oncogene overexpression in adenocarcinoma of the esophagus and gastroesophageal junction. Ann Surg Oncol 1999;6(3):290-7
- Parsonnet J, Vandersteen D, Goates J, et al. Helicobacter pylori infection in intestinal- and diffuse-type gastric adenocarcinomas. J Natl Cancer Inst 1991;83(9):640-3
- Qiu MZ, Cai MY, Zhang DS, et al. Clinicopathological characteristics and prognostic analysis of Lauren classification in gastric adenocarcinoma in China. J Transl Med 2013;11:58.
- Stiekema J, Cats A, Kuijpers A, et al. Surgical treatment results of intestinal and diffuse type gastric cancer. Implications for a differentiated therapeutic approach?. Eur J Surg Oncol 2013;39(7):686-93.
- National Cancer Institute. Surveillance, epidemiology and end results: incidance, stomach cancer. Available from: http://seer.cancer.gov/statfacts/html/stomach.html, giriş tarihi:15.07.2020
Epidemiology and survival characteristics of patients with gastric cancer in Ege Unıversity database
Öz
Aim: The aim of this study was to determine the epidemiologic and survival characteristics of gastric
cancer (GC) patients.
Materials and Methods: Data of Ege University Cancer Control and Research Center (EÜKAM)
between 1992-2017 were screened retrospectively. Data recorded in computer program CAN-REG-4
were categorized according to the World Health Organisation and Surveillance, Epidemiology, and
End Results systems and analyzed. Chi-square test, General Linear Model, and Kaplan-Meier survival
analysis were used for statistical analysis. Ethical approval was obtained.
Results: Out of a total of 117,139 cancers registered in the EÜKAM database, 4,212 (3.6%) were GC.
Among the gastrointestinal cancers, GC (21.6%) was the second most frequent after colorectal
cancers. 2,692 (63.9%) of the patients were male, 1,520 (36.1%) were female, the difference was
found significant (p<0.0001). The male/female ratio was 1.8. GC was most commonly seen between
60-69 years (28.9%). The most common location was corpus (31.2%), followed by antrum and cardia.
Distal (non-cardia) tumors were approximately 2.5 times more frequent than proximal (cardia) tumors.
Adenocarcinoma was the most common (73.6%) histological subtype. GC was detected at more
advanced stages in men than in women (p<0.0001). Most of the patients were diagnosed at locally
advanced or metastatic stages. Numerical linear increase was detected in GC cases in the last 25
years (GLM: F=15.9; p<0.0001). The median survival was 16 months. The 5-year survival rate was
28.1%; women had significantly higher 5-year survival rates (32%) than males (25.6%) (p<0.0001).
Adenocarcinomas showed poorer prognosis with 22.1% of 5-year survival rate (p<0.0001). The
prognosis of diffuse type adenocarcinomas was worse than intestinal type (p=0.020). The best survival
rates were achieved in the early stage as expected. The 5-year survival rate was 61.8% at localized
stage, while it decreases to 32.4% in the locally advanced stage (p <0.0001).
Conclusion: The analysis of our 25 years-data revealed a linear increase in the number of cases over
the years. GC was found more common in men and most often between the ages of 60-69. The 5-year
survival was longer in women than in men. GC stage was the most important parameter in prognosis.
Anahtar Kelimeler
Kaynakça
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424.
- Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC Cancer Base No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, giriş tarihi: 15.07.2020.
- Yusefi AR, Bagheri Lankarani K, Bastani P, Radinmanesh M, Kavosi Z. Risk Factors for Gastric Cancer: A Systematic Review. Asian Pac J Cancer Prev 2018;19(3):591-603.
- De Angelis R, Sant M, Coleman MP et al. Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE--5-a population-based study. Lancet Oncol 2014;15(1):23-34.
- Lui FH, Tuan B, Swenson SL, Wong RJ. Ethnic disparities in gastric cancer incidence and survival in the USA: an updated analysis of 1992-2009 SEER data. Dig Dis Sci 2014 Dec; 59(12):3027-34.
- Bosman FT, Carneiro F, Hruban RH et al eds. WHO classification of tumours of the digestive system, vol. 3. 4th ed Lyon: International Agency for Research on Cancer, 2010.
- Lauren P. The Two Histological Main Types Of Gastric Carcinoma: Diffuse And So-Called Intestinal-Type Carcinoma. An Attempt at a Histo-Clinical Classification. Acta Pathol Microbiol Scand 1965;64:31-49.
- Haydaroğlu A, Sert F, Caner A. Ege Üniversitesi Hastanesi veri tabanındaki kanser olgularının epidemiyolojik ve genel sağ kalım özellikler. Ege Tıp Dergisi 2019;58 Ek sayı/ Supplement 1-9.
- TC Sağlık Bakanlığı Kanser İstatistikleri. 2016 Kanser İstatistikleri. Erişim: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/Trkiye_Kanser_statistikleri_2016.pdf (giriş tarihi:15 Temmuz 2020).
- Yalçın B, Zengin N, Aydın F et al. The clinical and pathological features of patients with gastric cancer in Turkey: A Turkish Oncology Group Study. Turkish Journal of Cancer 2006;36(3):108-115.
- Bor S, Vardar R, Ormeci N et al. Prevalence patterns of gastric cancers in Turkey: model of a developing country with high occurrence of Helicobacter pylori. J Gastroenterol Hepatol 2007 Dec; 22(12):2242-5.
- Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.
- Tural D, Selçukbiricik F, Akar E, Serdengeçti S, Büyükünal E. Gastric cancer: A case study in Turkey. J Can Res Ther 2013;9(4):644-8.
- Kaneko S, Yoshimura T. Time trend analysis of gastric cancer incidence in Japan by histological types, 1975- 1989. Br J Cancer 2001;84(3):400-5.
- Schwartz GK. Invasion and metastases in gastric cancer: in vitro and in vivo models with clinical correlations. Semin Oncol 1996;23(3):316-24.
- Polkowski W, van Sandick JW, Offerhaus GJ, et al. Prognostic value of Laurén classification and c-erbB-2 oncogene overexpression in adenocarcinoma of the esophagus and gastroesophageal junction. Ann Surg Oncol 1999;6(3):290-7
- Parsonnet J, Vandersteen D, Goates J, et al. Helicobacter pylori infection in intestinal- and diffuse-type gastric adenocarcinomas. J Natl Cancer Inst 1991;83(9):640-3
- Qiu MZ, Cai MY, Zhang DS, et al. Clinicopathological characteristics and prognostic analysis of Lauren classification in gastric adenocarcinoma in China. J Transl Med 2013;11:58.
- Stiekema J, Cats A, Kuijpers A, et al. Surgical treatment results of intestinal and diffuse type gastric cancer. Implications for a differentiated therapeutic approach?. Eur J Surg Oncol 2013;39(7):686-93.
- National Cancer Institute. Surveillance, epidemiology and end results: incidance, stomach cancer. Available from: http://seer.cancer.gov/statfacts/html/stomach.html, giriş tarihi:15.07.2020
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 |
Kaynak Göster