Arif AYDIN, Gökhan ECER, Muzaffer KILINÇ, Mehmet BALASAR, Nurullah ALTINKAYA, Hakan TAŞKAPU, Mehmet Giray SÖNMEZ

Radikal prostatektomi yapılmış intermediate risk prostat kanseri hastalarında postoperatif sonuçların karşılaştırılması

Amaç: Prostat kanseri erkeklerde en sık görülen malignitelerdendir. En uygun tedavi rejimini belirlemek için düşük, orta ve yüksek risk olarak sınıflara ayrılmaktadır. Orta(intermediate) risk prostat kanserinin tedavisi, bu sınıflandırma kapsamına giren hastaların heterojenitesinden dolayı tartışmalıdır. Son yıllarda bu hastalar daha iyi prognoz beklenen 'Favourable' ve daha kötü prognoz beklenen 'Unfavourable' grup olarak 2'ye ayrılmıştır. Intermediate risk prostat kanserinde tedavide aktif izlem, radikal prostatektomi ve radyoterapi seçenekleri mevcuttur. Materyal-Metod: 2016-2020 yılları arasında kliniğimizde prostat kanseri nedeniyle radikal prostatektomi yapılan intermediate risk grubundaki 36 hastayı retrospektif olarak değerlendirdik. Hastaları risk faktörlerine göre favourable ve unfavourable olmak üzere iki gruba ayırdık. Hastaların preoperatif prostat biyopsi ve radikal prostatektomi patoloji sonuçlarını, postop 3. ve 6. ay kontrol PSA sonuçlarını, cerrahi sınır pozitiflik oranlarını, klinik ve patolojik evreler arasındaki farkları SPSS programını kullanarak istatistiki olarak karşılaştırdık. Sonuç: Pozitif kor sayısı, postop 3. ve 6. ay PSA değerleri, pozitif kor sayısı, cerrahi sınır pozitifliği, radikal prostatektomi sonrası upstage olma oranının unfavourable grupta daha yüksek olduğu tespit edildi. Bu farklar istatistiksel olarak anlamlı değildi. Pozitif kor yüzdesi ise unfavourabla grupta istatistiksel olarak anlamlı şekilde daha yüksekti.(P<0,001) Tartışma: İntermediate risk prostat kanseri heterojen bir hastalık grubudur. Tedavi rejimleri belirlenirken yaş, ek hastalık, hasta beklentisi gibi faktörler göz önünde bulundurularak seçim yapılması önem arzetmektedir.

Anahtar Kelimeler:

Penil fraktür, Erektil Disfonksiyon, Penil Hematom

Comparison of postoperative results in intermediate risk prostate cancer patients with radical prostatectomy

Objective: Prostate cancer is one of the most common malignities in males. It is separated into low, intermediate and high risk groups to determine the most suitable treatment regimen. Treatment of average risk prostate cancer is controversial due to the heterogeneity of the patients included in this classification. In recent years, these patients were separated into two groups as 'Favourable' in which a better prognosis is expected and as 'Unfavourable' in which a worse prognosis is expected. Active surveillance, radical prostatectomy and radiotherapy are the available options for intermediate risk prostate cancer. Material and Method: We retrospectively evaluated 36 patients in intermediate risk group who had radical prostatectomy in our clinic due to prostate cancer between 2016 and 2020. We separated the patients into two groups as favourable and unfavourable based on risk factors. We statistically compared preoperative prostate biopsy and radical prostatectomy pathology results, postop 3 and 6 month control PSA results, surgical border positivity ratios and the differences between clinical and pathological stages of the patients using SPSS program. Results: Positive core number, post op. 3rd and 6th month PSA values, positive core count, surgical border positivity, post radical protatectomy upstaging ratio were detected higher in unfavourable group. These differences were statistically insignificant. Positive core percentage was statistically significantly higher in unfavourable group (P<0.001). Conclusion: Intermediate risk prostate cancer is a heterogeneous disease group. Treatment regimens should be selected by considering factors such as age, additional disease and patient expectation.

Keywords:

penile fracture, Erectile dysfunction, penile hematoma,

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