Robot yardımlı radikal prostatektomi sonrasında biyokimyasal rekürrensi predikte eden faktörler: tek merkez deneyimi

Year 2022, Volume: 14 Issue: 3, 70 - 76, 30.09.2022

Ferhat Yakup Suçeken , Eyüp Veli Küçük

https://doi.org/10.54233/endouroloji.1164973

Abstract

Amaç: Bu çalışmada uzun takip süresine sahip hastalarda Biyokimyasal Rekürrens (BCR) gelişimini predikte eden faktörleri araştırmayı hedefledik.
Gereç ve Yöntemler: Robot Yardımlı Radikal Prostatektomi (RARP) uygulanan 758 hastanın verileri geriye dönük olarak tarandı. Postoperatif dönemde prostat spesifik antijen (PSA) değerlerinin 0,2 ng/mL ve üzeri saptanması BCR olarak kabul edildi. BCR gelişmeyen grup Grup 1, BCR gelişen grup Grup 2 olarak sınıflandırıldı.
Bulgular: Ortalama yaş iki grup arasında benzerdi. BCR gelişen grupta PSA değerleri anlamlı oranda yüksek izlendi (p<0,001). BCR gelişen grupta biyopsi gleason skoru (GS), risk sınıflaması ve spesmene ait GS oranları anlamlı olarak yüksek izlendi (sırasıyla p=0,02, p<0,001, <0,001). BCR gelişen grupta pozitif cerrahi sınır (PSM), ekstra prostatik yayılım (EPE), seminal vezikül invazyonu (SVI) ve lenf nodu pozitifliği (LNI) oranları anlamlı olarak yüksek izlendi. Çok değişkenli analizlerde; PSA, risk sınıflaması, spesmene ait GS, PSM, SVI ve T evreleri anlamlı parametreler olarak izlendi.
Sonuç: BCR gelişimini predikte eden değerler PSA, risk sınıflaması, spesmene ait GS, PSM, SVI ve T evresidir. Bu konuda ortak kabul gören modellerin yaygınlaşması ile hasta yönetimi ve hasta beklentilerinin optimizasyonunun sağlanabileceği kanaatindeyiz.

Keywords

robot yardımlı radikal prostatektomi, biyokimyasal rekürrens, prostat kanseri, PSA

Factors predicting biochemical recurrence following robot-assisted radical prostatectomy: single-center experience

Abstract

Objective: In this study, we aimed to investigate factors predicting the development of biochemical recurrence (BCR) in our clinical experience with patients over a long follow-up.
Material and Methods: The data of 758 patients who underwent robot-assisted radical prostatectomy (RARP) were retrospectively reviewed. In the postoperative period, the prostate-specific antigen (PSA) value is measured as 0.2 ng/mL and above, regarded as biochemical recurrence (BCR). The non-BCR group was regarded as Group 1, and the BCR group as Group 2.
Results: The mean age was similar between the two groups. The PSA values ​​were significantly higher in the group that developed BCR (p<0.001). The biopsy Gleason score (GS), risk classification, and specimen GS were significantly higher in this group (p=0.02, p<0.001, and p<0.001, respectively). The BCR group also had statistically significantly higher positive surgical margin (PSM), extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph node invasion rates. According to the multivariate analyses, PSA, risk classification, specimen GS, PSM, SVI, and T stage were significant parameters in the prediction of BCR.
Conclusion: The parameters ​​that predict the development were determined as the PSA value, risk classification, specimen GS, PSM, SVI, and T stage. The widespread adoption of commonly accepted methods will help achieve better patient management and optimize patient expectations.

Keywords

robot assisted radical prostatectomy, biochemical recurrence, prostate cancer, PSA

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