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Mesane kanseri tedavisinde yaygın olarak uygulanan radikal sistoprostatektomi materyallerinde klinik bulgu vermeyen, insidental prostat kanserlerine sıklıkla rastlanmaktadır. Çalışmamızda, merkezimizde radikal sistoprostatektomi uygulanan hastalarda prostat kanseri insidansını, evresini, histopatolojik özellikleri ve bu tümörlerin prognoza etkisini değerlendirmeyi amaçladık. 2006 - 2020 arasında merkezimizde mesane kanseri nedeniyle radikal sistoprostatektomi uygulanan 499 hastaya ait dosyalar retrospektif olarak incelendi. İnsidental prostat tümörü 141 (%28,3) olguda tespit edildi. Tümörlerin tamamı prostat asiner adenokarsinomu olarak tanı aldı. 127 (%90,1) hasta pT2, 10 (%7,1) hasta pT3a ve 4 (%2,8) hasta pT3b tümöre sahipti. 35 (%24,8) hastada klinik olarak önemli prostat kanseri mevcuttu. Ameliyat öncesi artmış PSA değerine sahip 14 hastadan 4’ü klinik olarak anlamlı prostat tümörüne sahipti. Radikal sistoprostatektomi materyallerinde insidental prostat tümörü saptanma oranları yüksektir ancak tümörlerin çoğu klinik olarak önemsiz grupta yer alır. Serum PSA değerinin ameliyat öncesi insidental tümörü tespitinde faydası sınırlıdır. İnsidental prostat tümörüne sahip hastalarda olumsuz klinik seyir izlenmemekle birlikte prognozun asıl belirleyicisi mesane tümörüdür.
Incidental prostate cancer is often found in the radical systoprostatectomy materials that are widely used in the treatment of prostate cancer, which do not provide clinical findings. In our study, we aimed at evaluating the incidence, stage, histopathological characteristics and the prognostic effect of these tumors in patients with radical systoprostatectomy in our center. From 2006 to 2020, the records of 499 patients with radical systoprostatectomy due to cervical cancer were examined retrospectively. Human-idental prostate tumor was detected in 141 (28.3%). All of the tumors were diagnosed as prostate asiner adenocarcinoma. 127 (90%) patients had pT2, 10 (7.1%) patients had pT3a and 4 (2.8%) patients had pT3b tumors. 35 (24.8 percent) of patients had clinically significant prostate cancer. Four out of 14 patients with an increased pre-operative PSA value had clinically significant prostate tumors. The rates of detection of accidental prostate tumor in radical systoprostatectomy materials are high, but most of the tumors are in the clinically unimportant group. The benefit of the serum PSA value in the detection of pre-operative incidental tumors is limited. In patients with insidental prostate tumor, negative clinical trajectory is not observed, but the main determiner of the prognosis is the urethra tumor.
Incidental prostate cancers are frequently encountered in radical cystoprostatectomy materials, which are widely used in the treatment of bladder cancer. We aimed to evaluate incidental prostate cancer’s incidence, stage, histopathological features and their effect on prognosis in patients who underwent radical cystoprostatectomy in our center. 499 patients who underwent radical cystoprostatectomy for bladder cancer between 2006 and 2020 were retrospectively evaluated. Incidental prostate tumor was detected in 141 (28.3%) cases. All tumors were diagnosed as prostate acinar adenocarcinoma. 127 (90.1%) patients had pT2, 10 (7.1%) patients had pT3a and 4 (2.8%) patients had pT3b tumor. Clinically significant prostate cancer was present in 35 (24.8%) patients. Of the 14 patients with an increased PSA level preoperatively, 4 had a clinically significant prostate tumor. Incidence of incidental prostate tumor is high in radical cystoprostatectomy materials, but most of them are clinically insignificant. The benefit of preoperative evaluation of serum PSA for the detection of incidental tumors is controversial. Although an unfavorable clinical course is not observed in patients with incidental prostate tumor, the main determinant of prognosis is the bladder tumor.
Field : Sağlık Bilimleri
Journal Type : Ulusal
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