Süleyman TAĞCI, Cüneyt ÖZDEŞ, Yalçın KIZILKAN, Samet ŞENEL, Doruk DEMİREL, Binhan KAAN AKTAŞ, Cevdet Serkan GÖKKAYA, Süleyman BULUT

CAPRA-S ile radikal prostatektomi sonrası biyokimyasal rekürrens zamanı arasındaki ilişki

Amaç: Radikal prostatektomi (RP) sonrası biyokimyasal nüks süresi ile “ameliyat sonrası prostat risk değerlendirme” skoru (CAPRA-S) arasındaki ilişkiyi değerlendirmek.Gereç ve Yöntemler: Klinik lokalize prostat kanseri tanısı nedeniyle RP uygulanan 328 hastanın verileri retrospektif olarak değerlendirildi. Hastalar preoperatif PSA düzeyine ve RP spesmeninin patolojik özellikleri ve RP sonrası biyokimyasal nükse kadar geçen süre ile belirlenen CAPRA-S skoruna göre gruplara ayrıldı.Bulgular: Ortalama takip süresi 76.9 ± 34.5 aydı. Biyokimyasal nüks, olguların % 23,2’sinde (n: 69) saptandı. Bunların % 71’inde (n: 49) erken, % 29’unda (n: 20) geç nüks saptandı. CAPRA-S skoruna göre 186 (% 62,4) hasta düşük riskli, 66 (% 22,1) orta riskli ve 46 (% 15) hasta yüksek riskli olarak sınıflandırıldı. Tüm hastaların 3 ve 5 yıllık biyokimyasal nükssüz sağkalım oranları sırasıyla % 88,9 ve % 81,8 olarak belirlendi. Düşük CAPRA-S skoruna sahip hastaların, orta ve yüksek gruptaki hastalara göre istatistiksel olarak anlamlı derecede daha yüksek 3 ve 5 yıllık biyokimyasal nükssüz sağkalım oranına sahip olduğu belirlendi. RP sonrası erken biyokimyasal rekürrensin sadece lenf nodu tutulumu ile istatistiksel olarak anlamlı korelasyon gösterdiği belirlendi (OR: 2.42, % 95 CI: 1.07-5.47, p = 0.03).Sonuç: Bu çalışmanın sonuçları, RP sonrası biyokimyasal rekürrens riskini tahmin etmede etkili olan CAPRA-S skorunun RP sonrası biyokimyasal rekürrens zamanını tahmin etmede etkili olmadığını göstermiştir.

Anahtar Kelimeler:

Biyokimyasal nüks, CAPRA-S skoru, prostat kanseri, radikal prostatektomi

The relationship between the CAPRA-S and the time of biochemical recurrence following radical prostatectomy

Objective: In this study, we aimed to evaluate the relationship between biochemical recurrence time and the “cancer of the prostate risk assessment post-surgery” score (CAPRA-S) after radical prostatectomy (RP).Material and Methods: Retrospective evaluation was made of the records of 328 patients applied with RP for a diagnosis of clinically localized prostate cancer. The patients were separated into groups according to the CAPRA-S score determined according to the preoperative PSA level and pathological characteristics of the RP specimen and the biochemical recurrence time after RP.Results: The mean follow-up period was 76.9±34.5 months. Biochemical recurrence was determined in 23.2% (n:69) of the cases, as early recurrence in 71% (n:49) and late in 29% (n:20). According to the CAPRA-S score, 186 (62.4%) patients were classified as low risk, 66 (22.1%) as moderate risk, and 46 (15%) as high risk. The 3 and 5-year BRFS rates of all the patients were 88.9% and 81.8% respectively. Patients with a low CAPRA-S score were determined to have a statistically significantly higher 3 and 5-year BRFS rate than patients in the moderate and high groups. Early biochemical recurrence after RP was statistically significantly correlated only with lymph node involvement (OR: 2.42, 95% CI: 1.07-5.47, p=0.03). Conclusion: This study showed that the CAPRA-S score, which is effective in predicting the risk of biochemical recurrence after RP, was not effective in predicting the time of biochemical recurrence after RP.

Keywords:

Biochemical recurrence, CAPRA-S score, prostate cancer, radical prostatectomy,

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