Ürotelyal mesane kanseri tanısı ile radikal sistoprostatektomi yapılan hastalardaki rastlantısal prostat kanseri sıklığı ve klinik önemi

Year 2018, Volume: 13 Issue: 3, 16 - 21, 01.10.2018

Turgay Turan Yavuz Onur Danacıoğlu , Furkan Şendoğan Ramazan Gköhan Atış Turhan Çaşkurlu Asıf Yıldırım

Abstract

Amaç: Mesane tümörü nedeniyle radi-
kal sistoprostatektomi yapılan ve rastlantısal
prostat adenokarsinomu saptanan hastaların
insidansı, histopatolojik değerlendirme so-
nuçları ve onkolojik sonuçlara etkisinin ince-
lenmesi amaçlanmıştır.

Materyal ve Metod: Kliniğimizde Ocak
2010 ve Aralık 2017 tarihleri arasında mesane
tümörü tanısıyla radikal sistoprostatektomi
yapılan ve preoperatif prostat kanseri şüphesi
ve tanısı olmayan 190 hasta çalışmaya dahil
edildi. Hastalar rastlantısal prostat kanseri
saptanan ve saptanmayan grup olarak ikiye
ayrıldı. Her iki grup yaş, operasyon öncesi
PSA değeri, vücut kitle indeksi, mesane tü-
mör evresi, derecesi, eşlik eden karsinoma in
situ varlığı, cerrahi sınır pozitifliği, lenf nodu
tutulumu ve genel sağkalım açısından karşılaştırıldı.

Bulgular: Hastaların klinik ve histopatolojik verileri Tablo-1 ve Tablo-2’de özetlen-
miştir. Histopatolojik incelemede hastaların
43`ünde (%22,6) prostat adenokarsinomu
saptandı. Prostat kanseri saptanan hastalardaki operasyon öncesi ortalama PSA değeri
5,38 ng/ml ve prostat kanseri saptanmayan
grupta ortalama PSA değeri 2,72 ng/ml idi
(p=0,015). Ortalama takip süresi 26 ay (3-74)
idi. Prostat kanseri nüksü 5 (%11,6) hastada
saptandı. Beş yıllık genel sağkalım prostat
kanseri saptanan hastalar için %61, prostat
kanseri saptanmayan hastalar için %53 olarak sapandı (p=0,471).

Sonuç: Radikal sistoprostatektomi sonrası rastlantısal prostat kanseri görülme sıklığı yaş ile birlikte artmakta ancak hastaların
prognozunu kötü yönde etkilememektedir. Özellikle lokal ileri
prostat kanserli hastalarının dikkatli ve düzenli takip edilmeleri
gerekmektedir. 

Keywords

Prostat Kanser , Mesane Kanseri , Radikal Sistektomi

The frequency of the incidental prostate cancer of the patients that were diagnosed as bladder cancer and underwent radical cystectomy and the oncological outcomes

Abstract

Objective: The aim of this study was to
evaluate the incidence, histopathological results and oncologic outcome of patients who
underwent radical cystoprostatectomy for
bladder tumors and detected incidental pros-
tate adenocarcinoma.

Materials-Methods: 190 patients who
were not proved to have preoperative prostate
cancer and underwent radical cystoprostatectomy and diagnosed as prostate cancer as
a second cancer between January 2010 and
December 2017 were included in this study.
Patients were randomly divided into two
groups those with and without incidentally
prostate cancer. Both groups were compared
in terms of age, preoperative PSA value, body
mass index, stage and grade of bladder tumor,
accompanying of carcinoma in situ, surgical
margin positivity, lymph node involvement
and overall survival retrospectively.

Results: The clinical and the histopathological features of the patients were summarized on Table 1 and Table 2. Fourtthree of
the 190 patients (22.6 %) were detected prostate adenocarcinoma by the histopathological
evaluation. The mean preoperative PSA level
was 5.38 ng / ml in patients who had prostate cancer and the mean PSA value in the
group without prostate cancer was 2.72 ng/
ml (p=0,015). The mean duration of follow-up
was 26 (3-74) months. The biochemical recurrence was detected at 5 (11.6%) patients during the follow-up. When the two groups were evaluated for 5-year
survival rates that was 61% for patients with prostate cancer and
53% for patients without prostate cancer (p=0.471).

Conclusion: The incidence of incidental prostate cancer after
radical cystoprostatectomy increases with age but does not affect the
prognosis of patients. In particular, the patients with locally advanced
prostate cancer were needed to follow carefully and regularly. 

Keywords

rostate Cancer , Bladder Cancer , Radical Cystectomy

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