S. ÜN, O KOCA, H. TÜRK, H. TARHAN, R.T. DİVRİK

Düşük risk lokalize prostat kanserli hastalarda aktif izlem sonuçlarımız

Amaç: Düşük risk lokalize prostat kanseri tanılı hastalarda aktif izlem sonuçlarımızı değerlendirmek. Gereç ve Yöntem: Kliniğimizde düşük risk lokalize prostat kanseri tanısı alan ve aktif izlem seçeneğini kabul eden hastalar çalışmaya dahil edildi. Hastalar 3 ayda bir PSA, PRM (parmakla rektal muayene) ve yılda bir 12 kor prostabiopsisi ile takip edildi. Risk artışı veya hasta isteği küratif tedaviye geçme kriteri olarak belirlendi. Bulgular: Aktif izlem yapılan 45 hastadan en az bir re-biopsisi olan 20 hastanın verileri geriye dönük olarak incelendiOrtalama takip süresi 46 ay (12-144 ay) idi. 20 hastadan 6 tanesi küratif tedavi aldı (%30). Dört hasta (%20) Gleason skor artışı nedeniyle, 2 hasta (%10) kendi isteği ile küratif tedavi aldı. Aktif izlem yapılan hastaların 5i ( %29.4) birincyılda, 1i (%5.8) ikinci yılda küratif tedavi aldı. Hastaların ortalama küratif tedaviye geçme süresi 14 aydı. Sonuç: Aktif izlem düşük riskli hastalarda küratif tedavi şansını kaybetmeden hastaların tedavi komplikasyonlarından mümkün olduğunca korunmasını sağlamaktadır. Bu grup hastalarda tedavi uyumu açısından kabul edilebilir bialternatiftir.

Results of active surveillance in low-risk localized prostate cancer patients

Aim: To evaluate the results of active surveillance in low-risk prostate cancer patients. Materials and Methods: Patients who have been diagnosed with low-risk localized prostate cancer and accepted the active surveillance treatment option were included in the study. These patients were followed with PSA and DRE (digital rectal examination) examinations every three months and an annual 12-core prostate biopsy in our clinic. Increased risk and patient's preference determined the decision for curative treatment. Results: Data from 20 of the 45 patients under the active surveillance program and those who had at least one re- biopsy result were prospectively examined. The average follow-up period was 46 months (range 12-144 months). Six out of 20 patients (30%) were treated with curative intent. Due to an increase in Gleason score, 4 patients (20%), and 2 patients (10%), due to their own preferences, received curative treatment. Five (29.4%) of the active surveillance patients underwent curative treatment within the first year, and 1 patient (5.8%) within the second year. The mean period in undergoing treatment was 14 months. Conclusion: In low-risk patients, active surveillance ensures protection to the upmost degree from possible complications, without losing the chance of curative treatment. For this group of patients it is an acceptable alternative in terms of compliance with treatment.

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