Serdar AYKAN, Murat TÜKEN, Aykut BUĞRA ŞENTÜRK, Mustafa Zafer TEMİZ MD, Atilla SEMERCİÖZ

Radikal prostatektomi yapılan hastalarda transrektal prostat biyopsi sonuçlari ile radikal prostatektomi spesmen histopatolojilerinin uyumunun değerlendirilmesi

Amaç: Çalışmamızda transrektal prostat iğne biyopsisi (TRİB) ve radikal prostatektomi sonrası belirlenen uluslar arası ürolojik patoloji topluluğu (ISUP) skoru ve D’ Amico sınıflaması farklı olan hasta grubunda yaş, prostat spesifik antijen (PSA), vücut kitle indeksi (VKİ), prostat hacmi, prostatektomi sonrası patolojik tümör hacmi, pozitif kor sayısı, biyopsi-operasyon arası gecen gün gibi parametrelerin farklı olup olmadığının araştırılması amaçlandı.Gereç ve Yöntem: 2008 ve 2015 yılları arasında prostat kanseri nedeniyle radikal prostatektomi uygulanan 167 erkek hasta çalışmaya dahil edildi. Radikal prostatektomi sonrası ISUP derecesi ve D’Amico risk grubu TRİB sonuçlarına göre değişen ve aynı kalan hastalar gruplandırıldı. Yaş, PSA, VKİ, prostat hacmi, biyopsi pozitif kor sayısı, prostatektomi sonrası patolojik tümör hacmi, biyopsi-cerrahi arası gün parametreleri gruplar arasında karşılaştırıldı.Bulgular: Ortalama yaş 64,16±5,68, serum PSA düzeyleri ise 9,2±6,61 ng/ml saptandı. ISUP derecesi değişen ve aynı kalan gruplar arasında yaş, VKİ, prostat hacmi ve biopsi-operasyon arası gün parametrelerinde istatistiksel olarak anlamlı farklılık gözlenmedi. Postprostatektomi ISUP derecesi değişen grupta ise PSA (p=0,008), prostatektomi sonrası patolojik tümör hacmi (p=0,043) ve biyopsi pozitif kor sayısı (p=0,011) istatistiksel olarak yüksek bulundu. D’ Amico sınıflaması değişen ve aynı kalan gruplar arasında yaş, PSA, prostat hacmi, prostatektomi sonrası patolojik tümör hacmi, biyopsi pozitif kadran sayısı ve biyopsi-operasyon arası gün parametrelerinde anlamlı farklılık gözlenmedi. Sadece VKİ D’ Amico sınıflaması değişen grupta istatistiksel olarak anlamlı yüksek bulundu (p=0,034).Sonuç: Yüksek PSA ve VKİ‘ ne sahip biopsi pozitif kor sayısı fazla olan hastalarda TRİB ile belirlenenden daha yüksek riskli tümör olasılığından dolayı tedavi planlamasında küratif tedavilere yönelim uygun olabilir.

Anahtar Kelimeler:

Prostat Kanseri, Uluslar Arası Ürolojik Patoloji Topluluğu (ISUP) Skoru, D’ Amico Sınıflaması, Prostat Spesifik Antijen, Transrektal Prostat İgne Biyopsisi

Evaluation of the agrement between histopathology results of transrectal biopsy and radical prostatectomy specimens in patıent wıth radical prostatectomy

Aim: To investigate the effects of age, serum prostate-specific antigen (PSA) level, body mass index (BMI), prostate volume, post-prostatectomy tumor volume, positive core number and day from biopsy to the surgery on concordance between transrectal ultrasound guided prostate biopsy and post-prostatectomy biopsy results in terms of International Society of Urological Pathology (ISUP) and D’ Amico classification systems scores.Materials and Method: Between 2008- 2015, 167 men underwent radical prostatectomy were included to the study. Patients with changed and same ISUP and D’ Amico classification scores after prostatectomy were classified. Age, serum PSA level, BMI, prostate volume, post-prostatectomy tumor volume, positive core number and day from biopsy to the surgery were compared between the groups.Results: Mean age and PSA levels were 64.16±5.68 and 9.2±6.61 ng/ml, respectively. Mean age, BMI, prostate volume and day from biopsy to the surgery were similar between the patients with changed and same post-prostatectomy ISUP scores. Mean PSA level, post- prostatectomy tumor volume and positive core number were significantly increased in patients with changed post-prostatectomy ISUP scores (p=0.008, p=0.043 and p=0.011, respectively). Mean PSA level, age, prostate volume, post- prostatectomy tumor volume, positive core number and day from biopsy to the surgery were similar between the patients with changed and same post-prostatectomy D’ Amico scores. Only, mean BMI was significantly increased in patients with changed post-prostatectomy D’ Amico scores (p=0.034).Conclusion: Curative treatment approaches could be best option in patients with elevated serum PSA levels, higher BMI and increased positive core number because higher probability of high grade disease.

Keywords:

prostate cancer, International Society of Urological Pathology (ISUP), D’ Amico classification systems scores, prostate specific antigen, transrectal prostate needle biopsy,

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