Lenf Nodu Statüsünün Endometriyum Kanseri Olgularında Sağkalım ve Rekürrens İle İlişkisi

Abstract

ABSTRACT Buldukoğlu Osman Çağın, Relationship of Lymph Node Status with Survival and Recurrence in Patients with Endometrial Cancer - Hacettepe University Faculty of Medicine, Department of Internal Medicine, Thesis in Internal Medicine, Ankara, 2015. Endometrial cancer is the 7th most common cancer among women worldwide, with 287,000 new cases per year. It is also the most common gynecological malignancy of women in developed countries. Lymph node ratio is a concept that is being researched in various cancer types as a possible prognostic factor. Lymph node ratio is defined as the ratio of total number of excised metastatic lymph nodes to total number of excised lymp nodes. Increased LNR is associated with decreased survival in some cancer types. Our purpose with this study is to investigate the relationship of LNR and other lymph node parameters with disease-free survival and overall survival in patients with endometrial cancer. 376 patients diagnosed between 2003 - 2013; whom had their surgery in Hacettepe University Hospitals, had their specimen examined in Hacettepe University Department of Pathology and had their follow-up in Hacettepe University Hospitals were included into the study. Information about the patients were accessed through the automation system using the patients' numbers. Electronical database of the hospital was examined to reach patient data, including staging, pathological records and recurrence - survival status. Parameters with evidence on prognosis such as histological type, stage of the disease, grade of the tumor and lymphovascular invasion were all found to be statistically significantly associated with survival. Diameter of the lymph nodes were not associated with survival. Increased number of excised metastatic lymph nodes were found to be associated with decreased survival. LNR cut-off value was determined as 0.03 using statistical methods. Patients with LNR greater than 0.03 were found to have decreased PFS and OS in comparison to those with an LNR value of 0.03 or lower. LNR value of 0.1 was found as a statistically significant cut-off value for PFS and OS amongst cases with at least one metastatic lymph node. As a result, LNR was shown to be an independent prognostic factor in patients with endometrial cancer. Future studies should focus on a greater number of patients to define a precise threshold of LNR value; and implement this new prognostic factor to the daily practice. Key Words: Endometrial carcinoma, lymph node, lymph node count, lymph node ratio, prognosis, recurrence, survival.