Tümör Nüksünün İlk Bulgusu Aksiller ve İnguinal Dev Lenfadenopatilerde Cerrahi Tedavi Yaklaşimimiz ve Cerrahinin Sağ Kalima Etkisi

Abstract

OZ Amac: Cerrahi ve onkolojik tedavisi tamamlanmis hasta- larda, malign tumor nuksunun ilk bulgusu olarak karsimiza cikabilen lenf nodu tutulumlarinda yapilacak olan cerra- hi tedavinin hastanin sagkalimina etkisi tartismalidir. Bu calismada, primer kanser tedavisi sonrasinda nuksun ilk bulgusu olarak, aksiller ve inguinal bolgede tumor invaz- yonu olan dev lenfadenopati nedeniyle klinigimize konsul- te edilen dort hasta,retrospektif olarak incelenerek, tedavi yaklasimlarimiz ve yapilan prosedurlerin sagkalim oranina etkisini arastirilmasi amaclanmistir. Gerec ve Yontemler: Olgularin sagkalim sureleri, metas- tatik dev lenfadenopati eksizyonu ve postoperatif onkolojik tedavilerin tamamlanmasi sonrasinda radyolojik yontemler ve klinik veriler izlenerek degerlendirildi. Bulgular: Dev lenfadenopati nedeniyle 1 hastaya aksiller bolgeye, bolge 1,2,3 lenf nodu disseksiyonu, diger 3 hasta- ya genisletilmis inguinal lenf nodu disseksiyonu uygulandi. Disseksiyon materyali patoloji sonucu primer tumor metas- tazi ile uyumlu geldi. Postoperatif donemde onkolojik teda- vi surecleri baslandi. Olgularin yaklasik 20 aylik toplam takip sureleri icerisinde nuks ve metastaza rastlanmadi. Sonuc: Dev metastatik lenf nodu tutuumu sonrasi deger- lendirdigimiz olgularda, primer tumor tipi, klinik seyirler ile birlikte lenf nodu tutulumuna yonelik uyguladigimiz cerrahi prosedurler sonrasi sagkalim degerlendirilmistir. 5 yillik ortalama sagkalim icin henuz net bir katki saglandigi soylenmesede devam etmekte olan mevcut takip suresince nuks izlenmemis olmasi umut vericidir. ABSTRACT Cancer Cases in Five Year Period in the Secondary Health Care Institution of East Anatolia Region Objective: After completion of surgical and oncological primary treatment of cancers, the effect of lymphadenec- tomy on patients' survival is controversial in patients with giant lymphadenopathy which is the first sign of cancer re - currence. In this retrospective study we aimed to evaluate our treatment modalities and effect of surgery to survival in four patients with cancer relapse with giant inguinal and axillary lymphadenopathy. Material and Methods: The survey of the cases are eva- luated via radiological and clinic datas after exicision of metastatic giant lympadenopathy and after termination of postoperative oncological therapy. Results: Due to giant lympadenopathy, region 1-2-3 axil- lary lymp node dissection to one patient and expanded in- guinal lymph node dissection to three other patient were performed. The pathology of dissection material was matc- hed with the primary tumor metastase. Oncologic therapy sessions were started in postoperative period. During 20 months follow-up of the cases there was not any recurrence or metastasis. Conclusion: In the cases that were evaluated after giant metastatic lymph node involvement, we assessed primary tumor type, clinical course as well as survival after surgi- cal procedures that we performed for lymph node involve- ment. The survey is evaluated after clinical follow-up and primary tumor type with the surgery performed for lymph node invasion within the cases we evaluate after giant me- tastatic lymph node invasion. Although it's been said that there isn't any specific contribution to average 5 year sur - vival it raises hope that there wasn't any recurrence during the follow-ups.