Radikal Sistoprostatektomi Materyalinde İnsidental Prostat Kanseri Saptanan Olguların Klinikopatolojik Özellikleri

Abstract

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.

Keywords

• Adenokarsinom
• İnsidental
• Prostat
• Sistoprostatektomi

Clinicopathological Characteristics of Incidental Prostate Tumors Detected in Radical Cystoprostatectomy Materials

Abstract

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.

Keywords

• Adenocarcinoma
• Cystoprostatectomy
• Insidental
• Prostate

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