Neoadjuvan kemoterapi sonrası meme koruyucu cerrahide lokal nüksü etkileyen faktörler: Uzun dönem sonuçlarımız

Neslihan CABIOĞLU, Mahmut MÜSLÜMANOĞLU, Abdullah İĞCİ, Beyza ÖZÇINAR, Vahit ÖZMEN, Temel DAĞOĞLU, Yeşim ERALP, Maktav DİNÇER, Işık ASLAY, Ekrem YAVUZ, Mehtap TUNACI, Adnan AYDINER, Mustafa KEÇER
407 206

Öz


AMAÇ Meme kanserinde neoadjuvan kemoterapi sonrası meme koruyucu cerrahi (MKC) için uygun seçim kriterleri konusunda henüz konsensüs sağlanmamıştır. Bu çalışmada, neoadjuvan kemoterapi sonrası MKC yapılan hastalardaki uzun dönem sonuçları sunuldu. GEREÇ VE YÖNTEM Ocak 1991-Temmuz 2005 tarihleri arasında neoadjuvan kemoterapi verilen klinik evre 2 ve evre 3 toplam 244 hastadan MKC uygulanan 29 hasta çalışmaya alınarak lokal nükse etkili faktörler araştırıldı. BULGULAR TNM sınıflamasına göre kemoterapi öncesi hastaların biri T0, biri T1, 14'ü T2, 7'si T3, 6'sı T4 ve 2 hasta N0, 9 hasta N1, 17 hasta N2 ve 1 hasta N3 olarak değerlendirildi. İlk beş yılda 2 hastada (%7) ve 10 yılda toplam 4 hastada (%14) ipsilateral memede tümör nüksü saptandı. Beş yıllık ve 10 yıllık lokal nükssüz sağkalım oranları sırasıyla %91,5 ve %75 ve genel sağkalım oranları da sırasıyla %92 ve %78 bulundu. Lokal nükse etkili faktörler araştırıldığında kemoterapi öncesi T0-2 hastalarda T3-4 hastalara göre 10 yıllık lokal nükssüz sağkalım oranı daha yüksek bulundu (%86 ile %60; p=0,078). SONUÇ Lokal ileri meme kanserinde neoadjuvan kemoterapi sonrası meme koruyucu cerrahi başlangıç klinik evresi T0-2 hastalarda onkolojik olarak daha güvenle yapılabilmektedir.

Anahtar kelimeler


Meme neoplazmları,Neoadjuvant tedavi,Kombine tedavi uygulaması,Kemoterapi,Antineoplastik birleşik kemoterapi protokolleri,Mastektomi, segmental,Tekrarlama

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Referanslar


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