Prostat kanserinde lenf nodu metastazını tahmin etmede etken olan faktörler nelerdir?

Amaç: Prostat kanseri olan hastaların lenf nodu metastazını öngörmek için etkili olacak faktörler araştırıldı. Materyal ve Metotlar: Ocak 2005 ile Şubat 2011 tarihleri arasında, kliniğimizde prostat kanseri tanısı ile radikal prostatektomi (RP) ve pelvik lenf nodu diseksiyonu (PLND) ya da sadece PLND yapılan toplam 218 hasta değerlendirildi. Preoperatif PSA, hasta yaşı, preoperatif prostat biyopsisi, klinik evre, nihai patoloji, radyolojik incelemeler değerlendirilerek lenf nodu invazyonunu etkileyen faktörler araştırıldı. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 63,26±6,87 (45-76) , ortalama PSA değeri 13,11 ng/dl ve TRUSG ile ortalama prostat boyutu 50,2 gr olarak bulundu. Operasyon esnasında frozen pozitifliği nedeniyle sadece PLND yapılan 18 hastanın hepsinde ve PLND-RP yapılan 210 hastanın 10’unda (toplam 28 hasta) lenf nodunda tümör metastazı saptandı. Biyopsideki tümörün yerleşimi açısından gruplar karşılaştırıldığında, bazal yerleşimli tümörlerde LNİ oranı daha yüksek saptandı. (p=0,047) Yapılan univariate analizde en yüksek prediktif doğruluğu %88,1 ile pozitif kor yüzdesi ve biyopside tümörün tek veya çift taraflı olması göstermekte iken bunu %87,6 ile total-PSA ve %87,1 ile biyopsi Gleason skoru izledi. Multivariate analizde ise total-PSA biyopside pozitif kor yüzdesi ve biyopsi gleason skoru anlamlı olarak bulundu (p

What are the factors that affect the prediction of lymph node metastasis in prostate Cancer?

Objectives: To analyze the factors that will be effective in predicting lymph node metastasis in patients with prostate cancer Materials and Methods: Between January 2005 and February 2011, a total of 218 patients with prostate cancer had undergone radical prostatectomy (RP) and pelvic lymph node dissection (PLND), or just pelvic lymph node dissection in our clinic were evaluated. Preoperative PSA, patient age, preoperative prostate biopsy, clinical stage, final pathology, radiological examinations were evaluated to analyze the factors affecting lymph node invasion. Results: The average age of the patients were 63.26 ± 6.87 (45- 76). The mean PSA value was 13.11 ng/dl and the mean prostate size defined by TRUSG was 50.2 gr. Lymph node tumor metastasis was detected in postoperative pathological examination of 28 patients including all of the 18 patients who underwent only PLND due to positive frozen section and 10 of 210 patients who underwent PLND and RP. A higher rate of LNI was detected in tumors located in the basement when the biopsies of the tumor groups were compared in terms of location (p=0.047). The highest positive predictive accuracy was obtained as 88.1% with the percentage of positive core biopsy and whether the tumor was single-or double-sided, and followed by 87.60 with the total-PSA and 87.1 with biopsy Gleason score. In multivariate analyses, total-PSA, the percentage of the positive cores and the biopsy Gleason scores were found to be significant (p <0.02). Conclusion: We think our study will be helpful in selecting patients who will undergo pelvic lymph node dissection.

Kaynakça

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Kaynak Göster

Yeni Üroloji Dergisi
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005

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