{"id":3568,"date":"2025-04-22T22:44:12","date_gmt":"2025-04-22T22:44:12","guid":{"rendered":"https:\/\/haber360.com\/index.php\/2025\/04\/22\/preoperatif-naples-skoru-ile-oral-kanser-sagkalimi\/"},"modified":"2025-04-22T22:44:12","modified_gmt":"2025-04-22T22:44:12","slug":"preoperatif-naples-skoru-ile-oral-kanser-sagkalimi","status":"publish","type":"post","link":"https:\/\/haber360.com\/index.php\/2025\/04\/22\/preoperatif-naples-skoru-ile-oral-kanser-sagkalimi\/","title":{"rendered":"Preoperatif Naples Skoru ile Oral Kanser Sa\u011fkal\u0131m\u0131"},"content":{"rendered":"<p>A\u011f\u0131z bo\u015flu\u011fu skuam\u00f6z h\u00fccreli karsinom (OCSCC), d\u00fcnya genelinde y\u00fcksek morbidite ve mortalite oranlar\u0131yla onkolojide \u00f6nemli zorluklar te\u015fkil etmeye devam ediyor. Hastal\u0131\u011f\u0131n seyri genellikle tahmin edilemez oldu\u011fundan, \u00f6zellikle cerrahi sonras\u0131 s\u00fcre\u00e7te klinik kararlar\u0131 y\u00f6nlendirebilecek g\u00fcvenilir prognostik ara\u00e7lara ihtiya\u00e7 duyulmaktad\u0131r. Son d\u00f6nemde BMC Cancer\u2019da yay\u0131mlanan yeni bir \u00e7al\u0131\u015fma, Napoli Prognostik Skoru\u2019nun (NPS) cerrahi tedavi g\u00f6ren OCSCC hastalar\u0131n\u0131n sonu\u00e7lar\u0131n\u0131 \u00f6ng\u00f6rmede \u00f6nemli bir biyobelirte\u00e7 olarak \u00f6ne \u00e7\u0131kt\u0131\u011f\u0131n\u0131 g\u00f6steriyor.<\/p>\n<p>Bu retrospektif \u00e7al\u0131\u015fma, \u00c7in\u2019in orta kesiminde yer alan iki \u00f6nde gelen b\u00f6lgesel sa\u011fl\u0131k merkezinde 11 y\u0131l boyunca tedavi g\u00f6ren 589 hastan\u0131n kapsaml\u0131 verilerini analiz etti. Hastalar\u0131n demografik bilgileri ile birlikte t\u00fcm\u00f6r spesifik detaylar, beslenme durumlar\u0131 ve inflamasyon g\u00f6stergeleri gibi \u00e7e\u015fitli klinikopatolojik fakt\u00f6rler de\u011ferlendirildi. Ara\u015ft\u0131rmac\u0131lar, cerrahi \u00f6ncesi \u00f6l\u00e7\u00fclen NPS\u2019nin hem hastal\u0131ks\u0131z sa\u011fkal\u0131m (DFS) hem de genel sa\u011fkal\u0131m (OS) \u00fczerindeki korelasyonunu ortaya koymay\u0131 hedefledi.<\/p>\n<p>Napoli Prognostik Skoru, sistemik inflamatuar yan\u0131tlar\u0131 ve beslenme durumunu yans\u0131tan birle\u015fik bir indekstir. N\u00f6trofil-lenfosit oran\u0131, serum alb\u00fcmin d\u00fczeyi ve kolesterol seviyesi gibi parametreleri bir araya getirerek, hastan\u0131n biyolojik direncine \u00e7ok boyutlu bir bak\u0131\u015f a\u00e7\u0131s\u0131 sunar. \u00d6nceki \u00e7al\u0131\u015fmalarda birka\u00e7 malignitede NPS\u2019nin prognostik de\u011feri incelenmi\u015f olsa da, OCSCC ba\u011flam\u0131nda \u00f6nemi hen\u00fcz yeterince ayd\u0131nlat\u0131lamam\u0131\u015ft\u0131. Bu ara\u015ft\u0131rma, eksikli\u011fi gidermeye y\u00f6nelik \u00f6nemli bir ad\u0131m.<\/p>\n<p>\u00c7al\u0131\u015fmada kullan\u0131lan univaryant ve multivaryant Cox regresyon analizleri sonucunda, cerrahi s\u0131n\u0131r durumu, ekstra nodal uzan\u0131m (ENE), NPS, ya\u015fa g\u00f6re ayarlanm\u0131\u015f Charlson Komorbidite \u0130ndeksi (ACCI) ve Amerikan Kanser Komitesi (AJCC) evrelemesi gibi birka\u00e7 ba\u011f\u0131ms\u0131z prognostik fakt\u00f6r tespit edildi. \u00d6zellikle NPS, hem hastal\u0131ks\u0131z hem de genel sa\u011fkal\u0131m i\u00e7in g\u00fc\u00e7l\u00fc bir ba\u011f\u0131ms\u0131z belirleyici olarak \u00f6ne \u00e7\u0131kt\u0131. Bu durum, NPS\u2019nin klinik uygulamalarda risk s\u0131n\u0131fland\u0131rma arac\u0131s\u0131 olarak de\u011ferini art\u0131r\u0131yor.<\/p>\n<p>Y\u00fcksek NPS ile k\u00f6t\u00fc sa\u011fkal\u0131m sonu\u00e7lar\u0131 aras\u0131ndaki kuvvetli ili\u015fki, sistemik inflamasyonun ve beslenme yetersizliklerinin t\u00fcm\u00f6r agresifli\u011fini art\u0131rd\u0131\u011f\u0131 ve cerrahi sonras\u0131 hastan\u0131n dayan\u0131kl\u0131l\u0131\u011f\u0131n\u0131 azaltt\u0131\u011f\u0131n\u0131 g\u00f6steriyor. NPS\u2019nin sundu\u011fu nicel risk de\u011ferlendirmesi sayesinde, klinisyenler n\u00fcks veya mortalite riski daha y\u00fcksek hastalar\u0131 erken d\u00f6nemde tan\u0131mlay\u0131p, tedavi planlamalar\u0131n\u0131 bu do\u011frultuda \u015fekillendirebilirler.<\/p>\n<p>Ara\u015ft\u0131rman\u0131n dikkat \u00e7eken bir ba\u015fka boyutu, adjuvan (ameliyat sonras\u0131) radyoterapinin sa\u011fkal\u0131m \u00fczerine etkileri oldu. Kaplan-Meier analizleri, ileri evre (AJCC evre III-IVb) ve orta-y\u00fcksek NPS skoruna sahip hastalar\u0131n adjuvan radyoterapiden belirgin sa\u011fkal\u0131m faydas\u0131 sa\u011flad\u0131\u011f\u0131n\u0131 ortaya koydu. Bu bulgu, NPS\u2019nin sadece prognostik bir ara\u00e7 olmakla kalmay\u0131p, tedavi stratejilerinin ki\u015fiselle\u015ftirilmesinde de rehber olabilece\u011fini i\u015faret ediyor. B\u00f6ylece d\u00fc\u015f\u00fck risk grubundaki hastalar gereksiz radyoterapi y\u00fck\u00fcnden kurtulabilir.<\/p>\n<p>\u00d6te yandan, erken evre t\u00fcm\u00f6rl\u00fc (AJCC evre I-II) veya NPS skoru s\u0131f\u0131r olan hastalarda adjuvan radyoterapinin sa\u011fkal\u0131m \u00fczerinde anlaml\u0131 bir etkisi g\u00f6zlenmedi. Bu durum, tedavi a\u015f\u0131r\u0131 kullan\u0131m\u0131n\u0131n \u00f6n\u00fcne ge\u00e7mek ve d\u00fc\u015f\u00fck riskli hastalarda gereksiz tedaviye ba\u011fl\u0131 yan etkileri azaltmak ad\u0131na \u00f6nemli uyar\u0131lar i\u00e7eriyor. NPS\u2019nin tedavi algoritmalar\u0131na dahil edilmesi, hem etkinli\u011fi art\u0131racak hem de hasta morbiditesini d\u00fc\u015f\u00fcrecektir.<\/p>\n<p>NPS ile birlikte ECOG Performans Durumu ve ACCI gibi di\u011fer prognostik g\u00f6stergelerin kullan\u0131lmas\u0131n\u0131n, sa\u011fkal\u0131m tahminlerinin g\u00fcvenilirli\u011fini art\u0131rd\u0131\u011f\u0131 da vurguland\u0131. ECOG, hastan\u0131n fonksiyonel kapasitesini de\u011ferlendirirken, ACCI komorbid hastal\u0131k y\u00fck\u00fcn\u00fc ortaya koyar. Bu \u00e7ok y\u00f6nl\u00fc yakla\u015f\u0131m, sadece t\u00fcm\u00f6r biyolojisi de\u011fil, ayn\u0131 zamanda hastan\u0131n genel sa\u011fl\u0131k durumu ve iyile\u015fme potansiyeline dair kapsaml\u0131 bilgi sunuyor. Onkolojide hasta odakl\u0131 bu b\u00fct\u00fcnc\u00fcl model giderek \u00f6nem kazan\u0131yor.<\/p>\n<p>Ara\u015ft\u0131rman\u0131n metodolojisindeki sa\u011flaml\u0131k, geni\u015f ve iyi tan\u0131mlanm\u0131\u015f hasta kitlesi ile istatistiksel modellemenin titiz kullan\u0131m\u0131, sonu\u00e7lar\u0131n g\u00fcvenilirli\u011fini destekliyor. Uzun ve kapsaml\u0131 veri toplama s\u00fcresi, anlaml\u0131 uzun d\u00f6nem sa\u011fkal\u0131m analizlerine imkan vererek prognostik \u00e7\u0131kar\u0131mlar\u0131n derinli\u011fini art\u0131r\u0131yor. Bu kapsamda \u00e7al\u0131\u015fma, OCSCC alan\u0131ndaki literat\u00fcre de\u011ferli katk\u0131lar sunuyor.<\/p>\n<p>\u00c7al\u0131\u015fmadaki bulgular, NPS\u2019nin rutin cerrahi \u00f6ncesi de\u011ferlendirmelere entegre edilmesini \u00f6ne \u00e7\u0131kar\u0131yor. Risk tabakaland\u0131r\u0131lmas\u0131 sayesinde cerrahlar ve onkologlar, adjuvan tedavinin gereklili\u011fi ve yo\u011funlu\u011fu konusunda daha bilin\u00e7li kararlar alabilir. Y\u00fcksek riskli hasta grubuna y\u00f6nelik yak\u0131n postoperatif takip ve erken m\u00fcdahale \u015fanslar\u0131 artarken, d\u00fc\u015f\u00fck risklilerde gereksiz tedavi ve komplikasyonlar minimize edilir.<\/p>\n<p>Ayr\u0131ca bu \u00e7al\u0131\u015fma, OCSCC progresyonunun biyolojik temellerinin anla\u015f\u0131lmas\u0131na da katk\u0131 sa\u011fl\u0131yor. NPS bile\u015fenleriyle \u00f6l\u00e7\u00fclen sistemik inflamasyon, t\u00fcm\u00f6r mikro\u00e7evresinin yeniden \u015fekillenmesinde, anjiyogenezde, ba\u011f\u0131\u015f\u0131kl\u0131ktan ka\u00e7\u0131\u015f ve metastatik yay\u0131l\u0131mda kritik rol oynuyor. Beslenme durumu ise ba\u011f\u0131\u015f\u0131kl\u0131k cevab\u0131 ve yara iyile\u015fmesini do\u011frudan etkileyerek tedavi ba\u015far\u0131s\u0131n\u0131 belirleyen fakt\u00f6rlerden biri. Bu a\u00e7\u0131dan, NPS\u2019ye g\u00f6re ki\u015fiselle\u015ftirilen preoperatif beslenme ve inflamatuar m\u00fcdahalelerin faydas\u0131 ara\u015ft\u0131rmaya de\u011fer.<\/p>\n<p>NPS\u2019nin kullan\u0131m\u0131, \u00f6zellikle kaynaklar\u0131n s\u0131n\u0131rl\u0131 oldu\u011fu ve tedavi ki\u015fiselle\u015ftirilmesinin kritik oldu\u011fu b\u00f6lgelerde pratik ve maliyet etkin bir risk de\u011ferlendirme y\u00f6ntemi sunuyor. Laboratuvar parametrelerine dayanan bu skor, pek \u00e7ok klinik ortamda kolayl\u0131kla eri\u015filebilir ve uygulanabilir. Bu durum, sa\u011fl\u0131k sistemlerinin adaletli kaynak da\u011f\u0131l\u0131m\u0131nda da \u00f6nemli avantajlar kazand\u0131rabilir.<\/p>\n<p>Son olarak, bu ara\u015ft\u0131rma sonras\u0131 yap\u0131lacak prospektif \u00e7al\u0131\u015fmalar ile farkl\u0131 pop\u00fclasyonlarda NPS do\u011frulanmal\u0131 ve beslenme ya da inflamasyonun mod\u00fclasyonuna y\u00f6nelik tedavi yakla\u015f\u0131mlar\u0131 incelenmeli. Ayr\u0131ca molek\u00fcler-genetik biyobelirte\u00e7lerle entegrasyon sa\u011flayarak prognostik modeller daha da optimize edilebilir. Xu, Wu ve Cheng\u2019in \u00e7al\u0131\u015fmas\u0131, preoperatif onkolojik de\u011ferlendirmelerde sistemik inflamatuar markerlar ile klinik parametrelerin kombinasyonunun g\u00fcc\u00fcn\u00fc ortaya koyarak standartlar\u0131 y\u00fckseltiyor.<\/p>\n<p>\u00d6zetle, Napoli Prognostik Skoru, a\u011f\u0131z bo\u015flu\u011fu skuam\u00f6z h\u00fccreli karsinomunda g\u00fc\u00e7l\u00fc prognostik bir g\u00f6sterge olarak kar\u015f\u0131m\u0131za \u00e7\u0131k\u0131yor. Klinik uygulamalara dahil edilmesi, tahmin do\u011frulu\u011funu art\u0131rmak ve tedavi yakla\u015f\u0131mlar\u0131n\u0131 optimize etmek ad\u0131na \u00f6nemli bir d\u00f6n\u00fcm noktas\u0131 olacak. Nihai hedef, hasta sa\u011fkal\u0131m\u0131n\u0131 ve ya\u015fam kalitesini art\u0131rmakt\u0131r.<\/p>\n<p><strong>Ara\u015ft\u0131rma Konusu<\/strong>:<br \/>\nOral cavity squamous cell carcinoma (OCSCC) cerrahi sonras\u0131 hastal\u0131ks\u0131z ve genel sa\u011fkal\u0131m\u0131n \u00f6ng\u00f6r\u00fclmesinde preoperatif Naples Prognostic Score\u2019un prognostik de\u011feri.<\/p>\n<p><strong>Makale Ba\u015fl\u0131\u011f\u0131<\/strong>:<br \/>\nPrognostic significance of preoperative Naples prognostic score for disease-free and overall survival in oral cavity squamous cell carcinoma post-surgery<\/p>\n<p><strong>Web References<\/strong>:<br \/>\nhttps:\/\/doi.org\/10.1186\/s12885-025-14146-4<\/p>\n<p><strong>Doi Referans<\/strong>:<br \/>\nhttps:\/\/doi.org\/10.1186\/s12885-025-14146-4<\/p>\n<p><strong>Resim Credits<\/strong>:<br \/>\nScienmag.com<\/p>\n<p><strong>Anahtar Kelimeler<\/strong>:<br \/>\nbiomarkers for cancer prognosis, cancer survival predictors, clinicopathological factors in oncology, disease-free survival in oral cancer, neutrophil-to-lymphocyte ratio significance, nutritional status and cancer outcomes, oral cavity squamous cell carcinoma prognosis, overall survival in OCSCC, preoperative Naples Prognostic Score, retrospective study in cancer research, surgical treatment outcomes for oral cancer, systemic inflammatory response in cancer<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A\u011f\u0131z bo\u015flu\u011fu skuam\u00f6z h\u00fccreli karsinom (OCSCC), d\u00fcnya genelinde y\u00fcksek morbidite ve mortalite oranlar\u0131yla onkolojide \u00f6nemli zorluklar te\u015fkil etmeye devam ediyor. Hastal\u0131\u011f\u0131n seyri genellikle tahmin edilemez oldu\u011fundan, \u00f6zellikle cerrahi sonras\u0131 s\u00fcre\u00e7te klinik kararlar\u0131 y\u00f6nlendirebilecek g\u00fcvenilir prognostik ara\u00e7lara ihtiya\u00e7 duyulmaktad\u0131r. Son d\u00f6nemde BMC Cancer\u2019da yay\u0131mlanan yeni bir \u00e7al\u0131\u015fma, Napoli Prognostik Skoru\u2019nun (NPS) cerrahi tedavi g\u00f6ren OCSCC hastalar\u0131n\u0131n&#8230;<\/p>\n","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_yoast_wpseo_focuskw":"","rank_math_title":"","rank_math_description":"","rank_math_focus_keyword":"","_wpan_schema_json_ld":"","_wpan_ai_seo_metadata":"","_wpan_ai_seo_status":"","_wpan_ai_seo_policy":"","_wpan_ai_seo_faq_block":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[28],"tags":[2473,2476,2474,2475,2472],"tmauthors":[],"class_list":{"0":"post-3568","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-kanser","8":"tag-agiz-boslugu-skuamoz-hucreli-karsinom-prognostik-faktorler","9":"tag-naples-skoru-klinik-risk-siniflandirmasi","10":"tag-napoli-prognostik-skoru-inflamasyon-ve-beslenme","11":"tag-oral-kanser-cerrahi-sonrasi-sagkalim-tahmini","12":"tag-preoperatif-naples-skoru-oral-kanser-sagkalimi"},"jetpack_featured_media_url":"https:\/\/haber360.com\/wp-content\/uploads\/2025\/04\/Preoperatif-Naples-Skoru-ile-Oral-Kanser-Sagkalimi-1745361854.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/posts\/3568","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/comments?post=3568"}],"version-history":[{"count":0,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/posts\/3568\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/media?parent=3568"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/categories?post=3568"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/tags?post=3568"},{"taxonomy":"tmauthors","embeddable":true,"href":"https:\/\/haber360.com\/index.php\/wp-json\/wp\/v2\/tmauthors?post=3568"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}