Cavit CEYLAN, Samet ŞENEL, İbrahim KELEŞ

Lokalize Prostat Kanserinde Radikal Prostatektomi Sonrası Biyokimyasal Nükse Etki Eden Faktörlerin Değerlendirilmesi*

Amaç: Çalışmamızda lokalize prostat kanserinde radikal prostatektomi sonrası biyokimyasal nüks oranımızı etkileyen faktörleri retrospektif olarak incelemeyi amaçladık. Gereç ve Yöntem: Mart 2009 ve Şubat 2019 tarihleri arasında kliniğimizde lokalize prostat kanseri nedeniyle açık retropubik radikal prostatektomi uygulanan 84 hastada biyokimyasal nükse etki eden faktörler retrospektif olarak değerlendirildi. Hastaların preoperatif PSA değerleri, D’Amico risk sınıflandırmasına göre risk grupları, vücut kitle indeksleri, yaşı, postoperatif Gleason skoru ve biyokimyasal nükse kadar geçen süre bilgileri kayıt edildi. Biyokimyasal nüks, PSA değerinin ardışık iki kez ölçümlerde 0.2 ng/ml ve üstü olması ve artış göstermesi olarak kabul edildi. Bu faktörlerin biyokimyasal nüks ile ilişkili olup olmadıkları araştırıldı. Bulgular: Toplam 17 hastada (% 20.2) biyokimyasal nüks saptanırken, 67 (%79.8) hastada saptanmadı. Düşük riskli ve orta-yüksek riskli olarak iki gruba ayrılan lokalize prostat kanserli hastalarda biyokimyasal nüks oranları arasında istatistiksel anlamlı fark saptanmadı (p =0.251). Preoperatif PSA ve postoperatif Gleason skoru iki grup arasında istatistiksel olarak anlamlı düzeyde farklı bulundu (sırasıyla p =0.034 ve p =0.023). Sonuç: Preoperatif PSA ve postoperatif Gleason skoru biyokimyasal nükse etki eden faktörlerdir. Hastaların takibi D’Amico risk gruplarına göre kılavuzlar dikkate alınarak yapılmalı ancak gerekli durumlarda takibin kişiselleştirilmesi gerektiği göz ardı edilmemelidir.

Evaluation of Factors Affecting Biochemical Recurrence After Radical Prostatectomy in Localized Prostate Cancer

Objective: We aimed to analyze risk factors affecting biochemical recurrence rate after radical prostatectomy in localized prostate cancer, retrospectively. Material and Method: The factors affecting biochemical recurrence were evaluated retrospectively in 84 patients who underwent open retropubic radical prostatectomy for localized prostate cancer in our clinic between March 2009 and February 2019. Preoperative PSA values, risk groups according to the D'Amico risk classification, body mass indexes, age and postoperative Gleason scores were recorded. PSA value for biochemical recurrence was accepted as 0.2 ng/ml and above in two consecutive measurements. It was investigated whether these factors are related to biochemical recurrence or not. Results: Biochemical recurrence was detected in 17 patients (20.2 %) and wasn’t detected in 67 (79.8 %) patients. There was no significant difference between biochemical recurrence rates in patients with low-risk and intermediate-high risk localized prostate cancer (p =0.251). Preoperative PSA and Gleason scores were statistically different in these patients (p =0.034 and p =0.023 respectively). Conclusion: We found that preoperative PSA and postoperative Gleason score were significant as a parameter affecting biochemical recurrence in localized prostate cancer. Patient follow-up should be done according to the D'Amico risk groups considering the guidelines, but it should not be overlooked that the follow-up should be individualized if necessary.

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