Özet:

Objective: The aim of our study is to demonstrate that differentiating patients receiving a palliative approach to prostate cancer from candidates for definitive treatment using age and PSA value at initial presentation. Material and Method: The records of patients diagnosed with prostate cancer in our clinic and external centers and presenting to our clinic for treatment between 2007 and 2012 were examined retrospectively. Information was collected concerning patients’ ages at presentation, presentation PSA values, rectal examination findings at time of presentation, prostate volumes, transrectal ultrasonography (TRUS)-guided prostate biopsy results, imaging findings performed for staging purposes in patients with prostate cancer, and pathological specimens in operated patients.. Results: Mean age of patients was 70.85±8.40. Mean ages, PSA levels, percentage quadrant rates, and Gleason scores differed significantly depending on presence of metastasis (p<0.01). In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 exhibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quadrant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%. Conclusion: Decision in management should be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.

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