Radikal prostatektomi yapılan hastalarda lenf nodu invazyonunu öngören preoperatif nomogramların karşılaştırılması

Yıl 2023, , 16 - 22, 30.01.2023

Osman Can , Cemal Topal , Eyyüp Danış , Muammer Bozkurt , Emin Taha Keskin , Halil Lütfi Canat , Abdulmuttalip Şimşek

https://doi.org/10.54233/endouroloji.1202615

Öz

Amaç: Prostat kanserinin cerrahi tedavisinde radikal prostatektomiye bazı durumlarda pelvik lenf nodu diseksiyonu (PLND) da eklenmektedir. Hangi hastada PLND yapılması gerektiğini öngören bazı nomogramlar geliştirilmiştir. Çalışmamızda MSKCC, Briganti ve Partin nomogramlarının etkinliğini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Retrospektif olarak çalışmaya Eylül 2020 ile Ekim 2022 tarihleri arasında radikal prostatektomi ve PLND yapılmış prostat kanseri hastaları dahil edildi. Çalışmaya toplamda 94 hasta dahil edildi. Hastaların demografik verileri ve prostat spesifik antijen (PSA), klinik evre, gleason skoru, biyopsi özellikleri gibi verileri kullanılarak Briganti, MSKCC ve Partin nomogramına göre lenf nodu invazyonu oranları hesaplandı.
Bulgular: Radikal prostatektomi yapılan 94 hasta çalışmaya dahil edildi. Hastaların 15’inde lenf nodu invazyonu bildirilirken, 79 hastada saptanmadı. Hastaların Briganti, Partin ve MSKCC nomogramlarının eğri altında kalan alan değerleri sırasıyla 0,922, 0,825 ve 0,929 idi. Her 3 nomogramın doğruluk oranı istatistiksel olarak anlamlı şekilde başarılı idi.
Sonuç: MSKCC ve Briganti nomogramlarının lenf nodu invazyonunu öngörmedeki duyarlılığı Partine göre biraz daha yüksek bulunmuştur. Ancak Briganti, Partin’e ve MSKCC nomogramları prostat kanseri hastalarında lenf nodu invazyonunu öngörmede güvenle kullanılabilir.

Anahtar Kelimeler

Partin, MSKCC, Briganti, Prostat Kanseri

Comparison of preoperative nomograms predicting lymph node invasion in patients underwent radical prostatectomy

Öz

Objective: In some cases, pelvic lymph node dissection (PLND) is added to radical prostatectomy in the surgical treatment of prostate cancer. Some nomograms have been developed to predict which patient should undergo PLND. In our study, we aimed to evaluate the effectiveness of MSKCC, Briganti and Partin nomograms.
Material and Methods: Retrospectively, prostate cancer patients who underwent radical prostatectomy and PLND between September 2020 and October 2022 were included in the study. A total of 94 patients were included in the study. The rates of lymph node invasion were calculated according to the Briganti, MSKCC, and Partin nomograms using the demographic data of the patients and data such as prostate-specific antigen (PSA), clinical stage, gleason score, and biopsy characteristics.
Results: Ninety four patients who had radical prostatectomy were included in the study. While lymph node invasion was reported in 15 of the patients, it was not detected in 79 patients. The area under the curve (AUC)’s of the patients’ Briganti, Partin, and MSKCC nomograms were 0.922, 0.825, and 0.929, respectively. The accuracy rate of all 3 nomograms was statistically significant.
Conclusion: The sensitivity of MSKCC and Briganti nomograms in predicting lymph node invasion was found to be slightly higher than Partin nomogram. However, Briganti, Partin, and MSKCC nomograms can be used safely to predict lymph node invasion in prostate cancer patients.

Anahtar Kelimeler

Partin, MSKCC, Briganti, Prostate cancer

Kaynakça

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