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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).
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 the 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 recur after surgical orchectomy 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 average 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, sperm cord involvement, tunica albuginea involvement and rete testis involvement (p = 0.019), we saw the effect of stage on recurence risk(p = 0.019)
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)
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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