Radikal retropubik prostatektomi sonrası cerrahi sınır pozitifliği ile serum PSA düzeyi ve histopatolojik kriterler arasındaki ilişki

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dc.contributor.authorKandıralı, Engin
dc.contributor.authorArmağan, Abdullah
dc.contributor.authorÖzcan, Faruk
dc.contributor.authorEsen, Tarık
dc.contributor.authorAras, Necdet
dc.date.accessioned2021-06-23T18:41:48Z
dc.date.available2021-06-23T18:41:48Z
dc.date.issued2008
dc.departmentBAİBÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.description.abstractÇalışmanın amacı açık radikal retropubik prostatektomi (RRP) öncesi serum PSA düzeyi ve Gleason skorunun ameliyat sonrası cerrahi sınır pozitifliği üzerine olan etkisini incelemektir. Çalışmamıza sinir koruyucu olmayan açık radikal retropubik prostatektomi ve iki taraflı lenfadenektomi uygulanan ve ameliyat öncesi ve sonrası patoloji değerlendirmesi kliniğimizde yapılan 259 hasta alındı. Ameliyat öncesi PSA düzeyi, biyopsi Gleason skoru, ameliyat sonrası Gleason skoru, histopatolojik evre ile cerrahi sınır pozitifliği arasındaki ilişki incelendi. Tüm hasta grubunda cerrahi sınır pozitifliği %21,2 idi. Cerrahi sınır pozitifliği evre pT2, pT3a, pT3b ve pN1’de sırasıyla %2,6 (3), %26,7 (27), %50 (16) ve %69,2 (9) olarak bulundu. Ameliyat öncesi serum PSA düzeyi 10 ng/ml ve altında olan hastalarda CS pozitifliği %16,7, üstünde %27,6 idi (p<0.05). Biyopsi Gleason skoru 7’nin altında CS pozitifliği %17,5, 7 ve üstünde %33,9 bulundu (p<0.05). Final Gleason skoru 7’nin altında CS pozitifliği %13,6, 7 ve üstünde %34,6 idi (p<0.05). Serum PSA düzeyi ve biyopsi Gleason skoru arttıkça cerrahi sınır pozitifliği artmaktadır. Tedavi şekline karar vermede klinik ve patolojik ölçütler daha dikkatli değerlendirmelidir.en_US
dc.description.abstractIntroduction: Radical prostatectomy is a common therapeutic procedure applied when clinically organ confined prostate cancer is diagnosed. Unfortunately, approximately one third of patients who undergo radical prostatectomy have positive surgical margins, and these patients have increased risk of local and systemic cancer progression. The aim of this study is to determine the association between preoperative serum prostate specific antigen levels (PSA) and biopsy Gleason sum with surgical margin status in patients with prostate cancer treated by radical retropubic prostatectomy and bilateral pelvic lymphadenectomy. Materials and Methods: In this study, 259 patients who underwent radical retropubic prostetectomy and bilateral pelvic lymphadenectomy in our clinic with the diagnosis of organ confined prostate cancer were included. All patients were evaluated by detailed medical examination, digital rectal examination, serum PSA levels, and transrectal ultrasound-guided prostate biopsy. Pelvic computerized tomography, magnetic resonance imaging and bone scan were performed as clinically indicated. The correlation of data including preoperative serum PSA levels, biopsy Gleason sum, postoperative Gleason sum, and pathologic stage with postoperative surgical margin status was examined. Fisher’s exact test was used for statistical analysis and p values < 0.05 were considered statistically significant. Results: The mean age of patients was 64.4±6.1 years (range 46-78 years), and the mean preoperative serum PSA level was 11.3±14.1 ng/ml (range 0.6-150 ng/ml). The overall positive surgical margin rate was 21.2% (55/259). Histopathological evaluation of radical retropubic prostatectomy specimens revealed that 2.6% (n=3) of patients with pT2, 26.7% (n=27) with pT3a, 50% (n=16) with pT3b, and 69.2% (n=9) with pN1 had positive surgical margin. A positive surgical margin occurred in 16.7% of patients with a preoperative serum PSA level of 10 ng/ml or less compared to 27.6% of patients with serum PSA level greater than 10 ng/ml, and this difference was statistically significant (p<0.05). Of patients with biopsy Gleason sum 7 or greater, 33.9% had a positive surgical margin compared to 17.5% with biopsy Gleason sum less than 7; this difference was also statistically significant (p<0.05). Of patients with final Gleason sum 7 or greater, 34.6% had a positive surgical margin compared to 13.6% with Gleason sum less than 7 (p<0.05). Conclusion: When biopsy Gleason sum and/or serum PSA levels increase, positive surgical margin status increases. Biopsy Gleason sum and serum PSA levels provide an estimation of the risk for positive surgical margin; thus, this information may be useful for the stratification of patients who undergo radical retropubic prostatectomy.en_US
dc.identifier.endpage294en_US
dc.identifier.issn1300-5804
dc.identifier.issn1308-4631
dc.identifier.issue3en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage291en_US
dc.identifier.trdizinid85285en_US
dc.identifier.urihttps://app.trdizin.gov.tr/makale/T0RVeU9EVTE
dc.identifier.urihttps://hdl.handle.net/20.500.12491/3485
dc.identifier.volume34en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.institutionauthorKandıralı, Engin
dc.language.isotren_US
dc.relation.ispartofTürk Üroloji Dergisien_US
dc.relation.ispartofTurkish Journal of Urology
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectProstat Kanserien_US
dc.subjectProstat Spesifik Antijenen_US
dc.subjectCerrahi Sınır
dc.subjectGleason Skoru
dc.subjectProstate Cancer
dc.subjectProstate-Specific Antigen
dc.subjectSurgical Magrin
dc.subjectGleason Sum
dc.titleRadikal retropubik prostatektomi sonrası cerrahi sınır pozitifliği ile serum PSA düzeyi ve histopatolojik kriterler arasındaki ilişkien_US
dc.title.alternativeThe association of serum PSA levels and histopathological criteria with positive surgical margin in radical retropubic prostatectomyen_US
dc.typeArticleen_US

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