Onur Ceylan, Rabia Demirtas

Gleason skor 6 prostat kanserinin ekstraprostatik yayılımı: tek merkez deneyimi

Amaç: Son yıllarda tedavi komplikasyonlarından dolayı gleason skor (GS) 3+3:6 prostat kanserlerinde (PK) radikal tedavi yerine klinik izlem önerilmektedir. Radikal tedavi yerine klinik izlem uygulanmasının en önemli dezavantajlarından biri düşük dereceli PK’ da lokal agresif davranış görülebilmesidir. Çalışmamızda amacımız GS-6 PK’ da lokal agresif davranış olarak kabul edilen ekstraprostatik yayılım (EPY) görülme oranını araştırmaktır. Gereç ve Yöntemler: Çalışmamıza Ocak 2010-Mayıs 2019 yılları arasında bölümümüze radikal prostatektomi materyali olarak gönderilmiş prostatik adenokarsinom (GS 3+3:6) tanısı almış tersiyer patern içermeyen 119 materyal incelendi. Bu materyallerden kaçında EPY olduğu araştırıldı. Bulgular: Çalışmamızda olguların 16 tanesinde (%13,45) EPY tespit edildi. Bunlardan 5’ inde veziküla seminalis invazyonu (pT3b), 11’ inde veziküla seminalis invazyonu olmadan mesane boyun invazyonu (pT3a) izlendi. Sonuç: GS-6 PK tanısı alan olgularımızın %13,45' inde EPY (pT3a), %4,2' sinde seminal vezikül invazyonu (pT3b) izlememizden dolayı GS-6 PK’ nın EPY yapma olasılığının nadir olmadığını düşünüyoruz. Bu bulgularımızdan yola çıkarak klinik izlem uygulanan GS-6 PK' lı olguların EPY açısından daha dikkatli takip edilmesi gerektiğini savunuyoruz.

Anahtar Kelimeler:

Prostat Kanseri, Gleason Skor, Ekstraprostatik Yayılım

Extraprostatic extension of gleason 6 prostate cancer: single center experience

Objective: For Gleason Score (GS) 3+3:6 prostate cancer (PC) cases, recent guidelines recommend clinical follow-up instead of radical treatment due to complications. One of the most important disadvantages of clinical follow-up is that low-grade PC may include local aggressive behavior. Hence, our aim here was to investigate the incidence of extraprostatic extension (EPE), a local aggressive behavior, in GS6 PC cases. Material and Methods: We examined 119 materials diagnosed with prostatic adenocarcinoma (GS 3+3:6) with no tertiary pattern and that were sent to our department as radical prostatectomy materials between January 2010 – May 2019. We investigated how many of the materials had EPE. Results: We observed EPE in 16 (13.45%) of our cases. 5 of the cases had vesicula seminalis invasion (pT3b) and 11 had bladder neck invasion (pT3a) without vesicula seminalis invasion. Conclusion: Among our patients diagnosed with GS-6 PC, we observed EPE (pT3a) in 13.45% and vesicula seminalis invasion (pT3b) in 4.2%, which suggests that the possibility of EPE is not uncommon in GS-6 PC. Based on these findings, we argue that patients with GS-6 PC under clinical follow-up should be followed more carefully for EPE.

Keywords:

Prostate Cancer, Gleason Score, Extraprostatic Extension,

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