Endometrium Kanseri
Özet
Endometrial kanser (EC), düşük ve orta gelirli ülkelerde serviks kanserinden sonra en sık görülen ikinci, yüksek gelirli ülkelerde ise en sık görülen jinekolojik kanserdir. Gelişen tedavi yöntemlerine rağmen, EC'ye bağlı mortalite önemli bir sorun olmaya devam etmektedir. Artan insidans ve uzun sağkalım süreleri, hastalık prevalansının hızla yükselmesine yol açmakta ve bu durum uzun süreli hasta takibini gerektirmektedir.
Tedavi sonrası sürveyans, nüks endometrial kanserin erken tanısına olanak sağlaması nedeniyle kritik öneme sahiptir. Lokal nükslerin tedavi edilebilirliği göz önünde bulundurulduğunda, sağkalım oranlarını iyileştirmek için nükslerin izlenmesinde optimal zaman aralıklarının ve tanısal yöntemlerin belirlenmesi gereklidir. Endometrial karsinomlu hastaların takibi, öncelikli olarak semptom değerlendirmesi ve fizik muayene ile gerçekleştirilir. Nükslerin büyük bir kısmının ilk üç yıl içinde meydana gelmesi nedeniyle, bu dönemde izlem sıklığı artırılmaktadır.
Asemptomatik hastalarda rutin radyolojik görüntüleme, serum CA-125 düzeylerinin takibi ve vajinal sitoloji kullanımı önerilmemektedir. Bununla birlikte, yaşam süresi uzayan EC hastalarının artışı, hasta yükünü ve ekonomik maliyeti artırmakta, bu nedenle takip sürelerinin ve uygulanacak tetkiklerin standartlaştırılması giderek daha fazla önem kazanmaktadır.
Endometrial cancer (EC) is the second most common gynecologic cancer after cervical cancer in resource-limited countriesd and the most common gynecologic cancer in high-income countries. Despite advancements in treatment modalities, the associated mortality rate remains a significant concern. The rising incidence and extended survival rates have led to a rapid increase in disease prevalence, necessitating long-term patient monitoring.
Post-treatment surveillance plays a critical role in the early detection of recurrent endometrial cancer. Given the potential treatability of local recurrences, determining the optimal time intervals and diagnostic methods for monitoring is essential to improving survival outcomes. Follow-up of patients with endometrial carcinoma is primarily conducted through symptom assessment and physical examination. Since the majority of recurrences occur within the first three years post-treatment, follow-up frequency is typically increased during this period.
Routine radiological imaging, serum CA-125 level monitoring, and vaginal cytology are not recommended for asymptomatic patients. However, the growing number of EC patients with extended life expectancy has increased both patient burden and economic costs. Consequently, the standardisation of follow-up schedules and diagnostic tests is becoming increasingly important.
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