TY - JOUR T1 - Association of Apelin Levels with Lymph Node Invasion and Clinical Progression in Obese Patients Undergoing Radical Prostatectomy for Prostate Cancer TT - Radikal Prostatektomi Uygulanan Prostat Kanseri Hastalarında Apelin'in Advers Histopatoloji ve Sağkalımla İlişkisi AU - Tüfekci, Burak AU - Kazan, Hüseyin Özgür AU - Toprak, Kenan AU - Alhaddad, Samer Hussein Hadi AU - Isman, Ferruh AU - Yıldırım, Asıf PY - 2025 DA - June Y2 - 2025 DO - 10.33719/nju1603293 JF - The New Journal of Urology JO - New J Urol PB - Ali İhsan TAŞÇI WT - DergiPark SN - 3023-6940 SP - 71 EP - 78 VL - 20 IS - 2 LA - en AB - Objective: We aimed to determine the relationship between Apelin, an adipocytokine associated with neoangiogenesis, adverse histopathology such as extraprostatic extension, positive surgical margins, lymph node involvement, and high Gleason score, and survival in patients who underwent curative radical prostatectomy due to prostate cancer.Material and Methods: In this prospective cohort study, 88 patients who underwent radical prostatectomy with curative intent between March 2018 and January 2019 were included. Patients with any treatment for prostate cancer, including androgen deprivation therapy or radiotherapy, were excluded. In the study, Apelin levels in the serum samples of all patients were measured with commercially available ELISA kits (Elabscience, Houston, TX, USA) before radical prostatectomy was performed. The patients were divided into two groups: non-obese and obese, with a BMI of 30 kg/m2 as the limit. Patient characteristics, histopathological differences, prognosis, and Apelin levels were evaluated between the two groups. Results: In the study, 17 patients were obese, and 71 were non-obese; age, comorbidity index, lipid parameters, and PSA levels were similar. The mean Apelin levels were not different between the two groups (172.9 vs. 146.4, p=0.262). The clinical progression (CP) rate was higher in obese patients (29.4% vs. 2.8%, p=0.001), while the biochemical recurrence rates were similar between the groups. Higher Apelin levels were associated with lymph node invasion in obese patients (180.2 pN1 vs. 122.8 pN0, p=0.027), but this association was not observed in non-obese patients.Conclusion: The risk of CP following radical prostatectomy was higher in obese patients, and Apelin levels were associated with lymph node invasion in these individuals. KW - Apelin KW - Adipokine KW - Biochemical recurrence KW - Clinical Progression KW - Obesity KW - Prostate cancer N2 - Amaç: Prostat kanseri nedeniyle küratif radikal prostatektomi uygulanan hastalarda neoanjiyogenez, advers histopatoloji ve sağkalım ile ilişkili bir adipositokin olan Apelin arasındaki ilişki araştırılmıştır.Yöntem: Bu prospektif kohort çalışmasında, Mart 2018 ile Ocak 2019 arasında küratif radikal prostatektomi geçiren 88 hasta çalışmaya dahil edildi. Androjen deprivasyon tedavisi veya radyoterapi dahil olmak üzere prostat kanseri için herhangi bir tedavi gören hastalar dışlandı. Çalışmada, radikal prostatektomi yapılmadan önce tüm hastaların serum örneklerindeki Apelin düzeyi ticari olarak temin edilebilen ELISA kitleri (Elabscience, Houston, TX, ABD) ile ölçüldü. Hastalar obez ve obez olmayan olmak üzere iki gruba ayrıldı ve iki grup sınır vücut kitle indeksi 30 kg/m2 olarak belirlendi. İki grup arasında hasta özellikleri, histopatolojik farklılıklar, prognoz ve Apelin düzeyleri değerlendirildi.Bulgular: Çalışmada 17 hasta obez, 71 hasta obez değil; yaş, komorbidite indeksi, lipid parametreleri ve PSA düzeyleri benzerdi. Ortalama Apelin düzeyleri iki grup arasında farklı değildi (172,9'a karşı 146,4, p=0,262). Klinik progresyon(CP) oranı obez hastalarda daha yüksekti (%29,4'e karşı %2,8, p=0,001), biyokimyasal nüks oranları ise her iki grup arasında benzerdi.Sonuç: Radikal prostatektomi sonrası CP riski obez hastalarda daha yüksekti ve bu hastaların Apelin düzeyleri lenf nodu invazyonu ile ilişkiliydi. CR - 1. Amin Al Olama A, Dadaev T, Hazelett DJ, et al. 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