Yüksek riskli prostat kanserinde cerrahi ve radyoterapinin onkolojik sonuçlara etkisi

The effect of surgery and radiotherapy on oncological outcomes in high-risk prostate cancer

Özet

GİRİŞ ve AMAÇ: Yüksek riskli prostat kanseri hastalarında en iyi tedavi yaklaşımının ne olduğu, halen tartışmaya açık bir konudur. Önerilen tedavi yaklaşımları; cerrahi (radikal retropubik prostatektomi) veya radyoterapi (RT) + androjen deprivasyon tedavisi (ADT) dir. Çalışmamızda yüksek riskli prostat kanserinde cerrahi ve radyoterapinin onkolojik sonuçlarını karşılaştırdık

Abstract

INTRODUCTION: The best treatment approach is still a matter of debate in high-risk prostate cancer patients. Recommended treatment approaches are surgery (radical retropubic prostatectomy) or radiotherapy (RT) + androgen deprivation therapy (ADT). In our study, we compared the oncological outcomes of surgery and radiotherapy in high-risk prostate cancer. METHODS: Fifty patients who were treated with high-risk prostate cancer in our clinic were retrospectively studied between January 2008 and June 2015. Twenty patients with open radical retropubic prostatectomy (RRP) were included in the surgical group and 30 patients with RT + ADT therapy were included in the radiotherapy group. Groups were evaluated in terms of biochemical recurrence (BCN), biochemical recurrence-free survival (BFSR), cancer-specific survival (CFS), and overall survival (GFS). RESULTS: Mean age of the patients was calculated 65.9 , mean baseline PSA levels were 24.2 (range 1-94.9), and mean follow-up was 50.24 months . The follow-up period was 55.7 months in the surgical group and 46.6 months in the RT group. Patient age, initial PSA level and clinical stage were found higher in RT group but no significant statistical difference was found. According to biopsy and prostatectomy pathologies in the surgical group; 4 (20%) patients were upgrading and 10 (50%) patients were downstaging. Four patients (20%) which observed Gleason pattern 5 was detected biochemical recurrence. No pattern 5 was detected in the biopsy of any patient in the radiotherapy group. DISCUSSION AND CONCLUSION: Similar to many studies in the literature, we found that patients treated with RT + ADT in high risk prostate cancer had beter oncologic outcomes than those with RRP.