| Abstract | Cilj istraživanja: Cilj istraživanja je bio retrospektivno analizirati pojavnost, dob, patohistološku dijagnozu, FIGO stadij, rizične čimbenike, dijagnostiku, liječenje i preživljenje kod oboljelih od raka endometrija u Klinici za ženske bolesti i porode KBC-a Split u razdoblju od 1.1.2014. do 31.12.2018. godine.
Materijali i metode: Retrospektivno je analizirana medicinska dokumentacija povijesti bolesti iz Klinike za ženske bolesti i porode i Klinike za onkologiju i radioterapiju KBC-a Split. Analizirani su sljedeći parametri: godina dijagnosticiranja, dob pacijentice u trenutku postavljanja dijagnoze, patohistološka dijagnoza, zahvaćenost limfnih čvorova, limfokapilarna invazija, FIGO stadij, gradus, komorbiditeti (šećerna bolest, hipertenzija), paritet, metroragija, dijagnostika, liječenje i preživljenje (mjeseci).
Rezultati: Uočeno je blago povećanje incidencije raka endometrija u razdoblju od 2016.-2018. godine. Najviše pacijentica nalazi se u dobnoj skupini od 60 do 69 godina. Prosječna dob u trenutku dijagnosticiranja raka endometrija iznosi 64,6 godina. Najučestaliji patohistološki tip je endometrioidni karcinom (75,8 %). Limfokapilarna invazija (63,7 %) uglavnom nije bila prisutna. Većina pacijentica dijagnosticirana je u FIGO I stadiju bolesti (71,6 %). Najveći broj tumora bio je gradusa 1 (60,7 %). Kod 65 (19,6 %) pacijentica oboljelih od raka endometrija utvrđena je prisutnost šećerne bolesti. Od hipertenzije su oboljele 172 (52 %) pacijentice. Većina pacijentica, njih 195 (58,9 %), imalo je metroragiju kao simptom. 106 pacijentica (32 %) imalo je 2 poroda. Najčešće korištena dijagnostička metoda bila je frakcionirana kiretaža (73,4 %). Češće je korišten laparotomijski (82,8 %) od laparoskopskog pristupa. U liječenju se sve češće koristi minimalno invazivna kirurgija. Medijan preživljenja za karcinome endometrija iznosi 56,32 mjeseci (SD ± 0,847). Analizom preživljenja po Kaplan-Meieru utvrđena je statistički značajna razlika u duljini preživljenja ispitanica oboljelih od karcinoma endometrija u odnosu na FIGO stadij (p < 0,01), s obzirom na prisutnost limfokapilarne invazije (p < 0,01) i s obzirom na gradus tumora (p < 0,01). Analizom preživljenja po Kaplan-Meieru nije utvrđena statistički značajna razlika u duljini preživljenja ispitanica s obzirom na zahvaćenost limfnih čvorova (p = 0,062).
Zaključci: Žene sve češće obolijevaju od raka endometrija. Rak endometrija je češći u postmenopauzalnih žena. Endometrioidni karcinom je najčešći tumor tijela maternice. Žene oboljele od raka endometrija češće imaju šećernu bolest i hipertenziju. Najčešći simptom raka endometrija je metroragija. U liječenju se sve češće koristi minimalno invazivna kirurgija kao metoda izbora. Prognoza za karcinome endometrija bolja je u ranijim FIGO stadijima bolesti. |
| Abstract (english) | Aims and Objectives: Our goal was to retrospectively analyze the occurrence, age, pathohistological diagnosis, FIGO stage, risk factors, diagnosis, treatment and survival of endometrial cancer at the Department of Gynecology and Obstetrics of University Hospital Split in the 2014.-2018. period.
Materials and Methods: The medical records from Department of Gynecology and Obstetrics of University Hospital Split were analyzed retrospectively in a 5 years period (2014.-2018.). The following parametres had been analysed: patients' age at time of diagnosis, pathohistological diagnosis, lymph node involvement, lymphocapillar invasion, FIGO stage, gradus, comorbidity (diabetes, hypertension), parity, presence of metrorrhagia, pretreatment diagnostic evaluation, treatment and overall survival (months).
Results: Our study showed a significant increase in incidence of endometrial cancer for the 2016.-2018. period. In ourstudy, most of the patients were aged between 60 and 69 years. The median age at the time of diagnosis was 64,6. The most common patohistological type of endometrial cancer was endometrioid adenocarcinoma (75.8 %). In most of the cases (63.7 %), lymphocapillar invasion was not present. The highest number of patients had FIGO stage I disease (71.6 %) and gradus I histological type of tumor (60.7 %). In 65 (19.6 %) of patients with endometrial cancer, the presence of diabetes was confirmed and 172 (52 %) of the patients were suffering from hypertension. The largest number of patints, 195 (58.9 %), had metrorrhagia as a symptom. Most patients in our research had 2 births (32 %). The most frequently used diagnostic method was the fractionated curettage (73.4 %). Altough, laparotomy (82.8 %) was used more frequently than laparoscopic approach, our study showed that minimal invasive surgery has been increasingly used in treatment of endometrial cancer in 2014.-2018. period. Median overall survival for endometrial cancer is 56.32 months (SD ± 0.847). Survival analysis by Kaplan-Meier showed statistically significant difference in the overall survival length of subjects with endometrial cancer compared to FIGO stage (p < 0.01), considerning lymphocapillar invasion (p < 0.01) and gradus (p < 0.01). Survival analysis by Kaplan-Meier didn't show statistically significant difference in the overall survival length of subjects with endometrial cancer compared to lymph node involvement (p = 0,062).
Conclusions: Women are more and more affected by endometrial cancer. Endometrial cancer is more common in postmenopausal women. The most frequent type of endometrial cancer is endometrioid adenocarcinoma. Women with endometrial cancer are more likely to have diabetes and hypertension. The most common symptom of endometrial cancer is metrorrhagia. Treatment is increasingly used by minimally invasive surgery as a method of choice. The prognosis for endometrial cancer is better in earlier FIGO stages of the disease. |
