Metastatik safra kesesi kanserinde kemoterapinin yeri: Retrospektif değerlendirme
Metastatik safra kesesi kanserinde kemoterapinin yeri: Retrospektif değerlendirme
Yazar: Cihan, Şener; Babacan, Nalan; Odabaş, Hatice; Demirci, Nebi; Özdemir, Nuriye; Yazılıtaş, Doğan
Dergi: Cumhuriyet Tıp Dergisi, Vol. 36 No. 4, 2014
Anahtar kelimeler: Gallbladder cancer, advanced stage, chemotherapy, survival ; Safra kesesi kanseri, ileri evre, kemoterapi, sağkalım

ÖzetAmaç. Safra kesesi kanseri sıklıkla ileri evrede teşhis edilen ve prognozu kötü olan bir kanser türüdür. Literatürde safra kesesi kanseri tedavisi ile ilgili çalışmalar sınırlıdır. Bilgilerin çoğu karaciğer, pankreas ve diğer safra yolları kanserlerini de içeren çalışmalardan elde edilmiştir. Metastatik hastalıkta standart bir tedavi yaklaşım olmamakla birlikte çeşitli kemoterapötikler kullanılmaktadır. Çalışmamızda metastatik safra kesesi kanserinde kemoterapinin sağkalım üzerine etkisi araştırılmıştır. Yöntem. Metastatik safra kesesi kanserli 32 hastanın dosyaları retrospektif olarak incelenmiştir. Hastaların sağkalım süreleri kemoterapi alıp almamalarına göre değerlendirilmiştir. Bulgular: Kemoterapi alan 14 (%43,8) hastaların hem progresyonsuz hem de genel sağkalım verileri kemoterapi almayan 18 (%56,2) hastalara göre daha uzun ve istatistiksel olarak da anlamlı idi (p<0,001). Kemoterapi alan hastalarda progresyonsuz sağkalım 20 ± 2,9 (%14,3-25,7 CI) hafta, genel sağkalım 36 ± 11,2 (%14-58 CI) hafta idi. Kemoterapi almayan hastalarda ise progresyonsuz sağkalım 4 ± 0,4 (%3,2-4,8 CI) hafta ve genel sağkalım ise 12 ± 2,8 (%6,5 x 17,5 CI) hafta olarak bulundu. Gemsitabin/sisplatin ve sisplatin/5-fluorourasil kombinasyonları en sık kullanılan rejimlerdi. Sonuç. Çalışmamız neticesinde metastatik safra kesesi kanserinde uygun hasta seçiminde kemoterapinin sağkalım üzerinde olumlu etkisi olduğu gösterilmiştir.Anahtar sözcükler: Safra kesesi kanseri, ileri evre, kemoterapi, sağkalım AbstractAim. Gallbladder cancer (GBC) is often diagnosed at advanced stage and prognosis is very poor. Information about the treatment of gallbladder cancer in the literature is limited. Most of the information were obtained from studies which involving liver, pancreas and other bile duct cancer. There is no standard therapy for metastatic disease. Various chemotherapeutic agents are used in the metastatic disease. In our study, effect of chemotherapy on survival in metastatic gallbladder cancer were investigated. Methods. Medical records of 32 patients with metastatic gallbladder cancer were evaluated retrospectively. Result. Both overall survival and progression free survival was longer in 14 (43.8%) patients receiving chemotherapy. This diversity was statistically significant (p<0.001). Progression-free survival was 20 ± 2.9 (14.3-25.7% CI) weeks and overall survival was 36 ± 11.2 (14-58% Cl) weeks in the patients receiving chemotherapy. On the other hand progression-free survival was 4 ± 0.4 (3.2-4.8% CI) weeks and overall survival was 12 ± 2.8 (6.5 x 17.5% CI) weeks in patients that didn’t receive chemotherapy. Gemcitabine/cisplatin and cisplatin/5-fluorouracil combinations were the most commonly used regimens. Conclusion. This study suggests that the positive effect of chemotherapy on survival in metastatic gallbladder cancer.Keywords: Gallbladder cancer, advanced stage, chemotherapy, survival

Aim. Gallbladder cancer (GBC) is often diagnosed at advanced stage and prognosis is very poor. Information about the treatment of gallbladder cancer in the literature is limited. Most of the information were obtained from studies which involving liver, pancreas and other bile duct cancer. There is no standard therapy for metastatic disease. Various chemotherapeutic agents are used in the metastatic disease. In our study, effect of chemotherapy on survival in metastatic gallbladder cancer were investigated. Methods. Medical records of 32 patients with metastatic gallbladder cancer were evaluated retrospectively. Result. Both overall survival and progression free survival was longer in 14 (43.8%) patients receiving chemotherapy. This diversity was statistically significant (p