PROGNOSTIČKE RAZLIKE TUBO- OVARIJALNOG SEROZNOG KARCINOMA VISOKOG GRADUSA U STADIJUMU IIIC
Sažetak
Kvantitativne varijacije u peritonealnoj karcinomatozi i veličini primarnog pelvičnog tumora (engl. tumor size – TS) mogu odražavati raznolikost u seroznom karcinomu visokog gradusa (engl. high-grade serous cacinoma – HGSC) u stadijumu IIIC. Indeks peritonealnog kancera (engl. the peritoneal cancer index – PCI) daje precizan dokaz o proširenosti i lokalizaciji volumena tumora. Cilj ove studije bio je da se istraži postojanje razlika između HGSC-a u stadijumu IIIC FIGO klasifikacije (International Federation of Gynecology and Obstetrics – FIGO) na osnovu lokalizacije najvećeg volumena tumora i uticaja lokalizacije na ukupno preživljavanje (OS). Pregledana je medicinska dokumentacija primarnih tubo-ovarijalnih HGSC-a od januara 2019. do decembra 2022. godine. Bolesnice su podeljene u dve grupe: grupu sa PCI-jem ≤ 10 i velikim TS-om (Grupa 1, n = 39) i grupu sa PCI-jem > 10 i malim TS-om (Grupa 2, n = 36). Grupa 2 je imala značajno veću zapreminu ascitne tečnosti (p = 0,017). Optimalna citoredukcija (OC) postignuta je kod 53,9% bolesnica u Grupi 1 i samo kod 11,1% bolesnica u Grupi 2 (p < 0,001). BRCA1/2 mutacija bila je značajno češća u Grupi 1 (p = 0,012). Ukupno preživljavanje bilo je značajno bolje u Grupi 1 nego u Grupi 2 (p < 0,001). Multivarijantna analiza identifikovala je grupu, volumen ascitesa i kompletnost citoredukcije kao nezavisne prognostičke faktore preživljavanja. FIGO stadijum IIIC HGSC-a trebalo bi da evoluira od univerzalnog pristupa do indvidualizovanog pristupa kada je reč o upotrebi hirurgije, hemioterapije i ciljane terapije. Lokalizacija najvećeg volumena tumora predstavlja faktor koji čini prognostičku razliku u stadijumu IIIC HGSC-a.
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