Radikal prostatektomi sonrası PSA relapsına tanısal ve tedavi yaklaşımı

Yıl 2015, Cilt: 7 Sayı: 4, 201 - 204, 01.12.2015

Süleyman Yeşil Fazlı Polat Ali Atan

Öz

Radikal prostatektomi RP sonrası hastaların %20-30’unda klinik veya radyolojik metastaz bulgusu olmadan PSA artışı olur. RP sonrası meydana gelen PSA relapsı prostatik yataktaki lokal hastalığa, pelvik lenf nodlarındaki bölgesel hastalığa, uzak metastaza veya lokal ve uzak metastaz kombinasyonuna bağlı olabilir. Bu durumlardan hangisine bağlı PSA relapsı olduğunu öngörmede ilk PSA değeri, PSA relaps zamanı ve PSA ikilenme zamanı çok önemlidir. RP sonrası biyokimyasal relaps BKR tedavi zamanı ve şekli tartışmalıdır. PSA relapslı hastaların tedavisinde dikkate alınması gereken noktalar hastanın beklenen yaşam beklentisi, PSA artışının lokal veya sistemik hastalığın hangisinden kaynaklandığı, klinik progresyon riski ve PSA düzeyi ve kinetiği’dir. Prostatik yatağa radyoterapi, androjen deprivasyon tedavisi ve gözlem bu hastalarda düşünülebilecek tedavi yöntemleridir

Anahtar Kelimeler

Prostat kanseri, radikal prostatektomi, PSA relapsı

Diagnostic and therapeutic approach to PSA relaps after radical prostatectomy

Öz

After radical prostatectomy RP , 20-30% of the patients has PSA relaps without clinical or radiologic findings of the metastasis. PSA relaps after RP may be due to local disease in the prostatic bed, nodal involvement in pelvic area, distant metastasis or combination of local and metastatic disease. First PSA level, PSA relaps time and PSA doubling time are very important to predict the reason of PSA relaps after RP. Treatment type and treatment time of PSA relaps after RP are controversial. Expected life time, the reason of PSA relaps as local or metastatic disease, risk of clinical progression, PSA level and PSA kinetics are important criteria to be considered in the treatment of these patients. Radiation therapy to prostatic bed, androgen deprivation therapy and watchfull waiting are options for the treatment

Anahtar Kelimeler

Prostate cancer, radical prostatectomy, PSA relaps

Kaynakça

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