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Frailty Önemlidir: Modified Frailty Index-5 Skorunun Radikal Prostatektomide Postoperatif Sonuçları Öngörmede Başarısı

Frailty Matters: The Success of the Modified Frailty Index-5 Score in Predicting Postoperative Outcomes in Radical Prostatectomy

Osman Murat İpek(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0002-1305-023X
Erdinç Dinçer(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0002-0644-8282
Ahmet Halil Sevinc(Kartal Dr. Lütfi Kırdar Şehir Hastanesi)0000-0003-2965-1782
Burcu Hanci Sevinc(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0001-6928-1654
Cengiz Çanakcı(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0002-2654-1986
Yiğit Kudret Akyol(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0002-3647-2603
Orkunt Özkaptan(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL KARTAL DR. LÜTFİ KIRDAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0003-3659-1319
Sayfa
141–149
Yayın Tarihi
2026-09-30
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Demografik özellikler, komorbidite profilleri, histopatolojik bulgular, perioperatif değişkenler, postoperatif komplikasyonlar ve takip sonuçları değerlendirilmiştir.

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Amaç & Hipotez:Amaç: Radikal prostatektomi uygulanan hastalar genellikle ileri yaş popülasyonuna aittir; bu nedenle kronolojik yaşa ek olarak, frailty (kırılganlık) klinik sonuçlar üzerinde önemli bir etkiye sahiptir.
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Temel Bulgular & Veri:Bu çalışmanın amacı, radikal prostatektomi uygulanan hastalarda modifiye frailty indeksinin (mFI-5) postoperatif komplikasyonlar ve fonksiyonel sonuçlarını öngörmedeki başarısını değerlendirmektir.
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Sonuç & Katkı:Demografik özellikler, komorbidite profilleri, histopatolojik bulgular, perioperatif değişkenler, postoperatif komplikasyonlar ve takip sonuçları değerlendirilmiştir.
🔬Tür:Araştırma Makalesi
📍Kapsam:2016 · 200 hasta
⚙️Değişkenler:prostat kanseri · radikal prostatektomi · modifiye kırılganlık indeks-5

Özet

Amaç: Radikal prostatektomi uygulanan hastalar genellikle ileri yaş popülasyonuna aittir; bu nedenle kronolojik yaşa ek olarak, frailty (kırılganlık) klinik sonuçlar üzerinde önemli bir etkiye sahiptir. Bu çalışmanın amacı, radikal prostatektomi uygulanan hastalarda modifiye frailty indeksinin (mFI-5) postoperatif komplikasyonlar ve fonksiyonel sonuçlarını öngörmedeki başarısını değerlendirmektir. Gereç ve Yöntemler: Ocak 2016 ile Ocak 2024 tarihleri arasında yüksek hacimli bir üçüncü basamak merkezde radikal prostatektomi uygulanan 200 hastanın verileri retrospektif olarak analiz edilmiştir. Demografik özellikler, komorbidite profilleri, histopatolojik bulgular, perioperatif değişkenler, postoperatif komplikasyonlar ve takip sonuçları değerlendirilmiştir. Hastalar, preoperatif mFI-5 skorlarına göre yüksek risk (≥ 2) ve düşük risk (< 2) olarak sınıflandırılmıştır. Postoperatif komplikasyonlar birincil sonlanım noktası olarak belirlenirken, fonksiyonel sonuçlar ikincil sonlanım noktaları olarak değerlendirilmiştir. Bulgular: Çalışmaya 200 erkek hasta dahil edilmiş olup, ortalama yaş 64,7 ± 6,03 yıl olarak bulunmuştur. 200 hastanın 54’ü (%27) yüksek risk grubunda (mFI-5 ≥ 2), 146’sı (%73) ise düşük risk grubunda (mFI-5 < 2) yer almıştır. Majör komplikasyon oranı (Clavien-Dindo ≥ 3) yüksek risk grubunda anlamlı derecede daha yüksek bulunurken, toplam komplikasyon oranı gruplar arasında benzer saptanmıştır. Tekrar başvuru ve re-operasyon oranları yüksek risk grubunda daha yüksek bulunmuş, ancak bu fark istatistiksel anlamlılığa ulaşmamıştır. Fonksiyonel sonuçlar açısından, erektil disfonksiyon ve üriner inkontinans oranlarının gruplar arasında benzer olduğu görülmüştür. Sonuçlar: Bu çalışma, radikal prostatektomi uygulanan hastalarda daha yüksek mFI-5 skorları ile daha yüksek majör komplikasyon oranları arasındaki ilişkiyi ortaya koymaktadır. Frailte değerlendirmesinde basit ve maliyet etkin bir ölçüt olan mFI-5, bu hasta grubunda preoperatif risk sınıflandırması ve hasta seçimi açısından önemli bir rol oynayabilir.

Abstract

Objective: Patients undergoing radical prostatectomy generally belong to an older population; therefore, in addition to chronological age, frailty has a substantial impact on clinical outcomes. This study aimed to evaluate the predictive value of the modified frailty index (mFI-5) for post-operative complications and functional outcomes in patients undergoing radical prostatectomy. Materials and Methods: A retrospective analysis was conducted on 200 individuals who underwent radical prostatectomy between January 2016 and January 2024 in a high-volume tertiary center. Data collection included demographic characteristics, comorbidity profiles, histopathological findings, perioperative variables, postoperative complications and follow-up outcomes. Patients were stratified as having either high risk (≥ 2) or low risk (< 2) according to pre-operative mFI-5 scores. Postoperative complications constituted the primary endpoint, whereas functional outcomes were assessed as secondary endpoints. Results: The study included 200 male patients, with a mean age of 64.7 ± 6.03 years. Fifty-four out of 200 patients (27%) were in the high-risk group (mFI-5 ≥ 2) while 146 patients (73%) were in low-risk group (mFI-5 < 2). While the rate of major complications (Clavien-Dindo ≥ 3) was significantly higher in high-risk group, the overall complication rate was similar between the groups. Readmission and reoperation rates were increased in the high-risk group; however, the difference did not reach statistical significance. Regarding functional outcomes, erectile dysfunction and urinary incontinence rates were similar between the groups. Conclusion: This study highlights an association between higher mFI-5 scores and an increased risk of major postoperative complications after radical prostatectomy. Although mFI-5 should not be used as a stand-alone criterion for treatment selection, it may serve as a simple, rapid, and cost-effective adjunctive tool for preoperative risk stratification and individualized surgical decision-making.

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Bu Makaleye Atıf Yap

İpek, O. M., Dinçer, E., Sevinc, A. H., Sevinc, B. H., Çanakcı, C., Akyol, Y. K., Özkaptan, O. (2026). Frailty Önemlidir: Modified Frailty Index-5 Skorunun Radikal Prostatektomide Postoperatif Sonuçları Öngörmede Başarısı. Endoüroloji Bülteni, Cilt: 18 Sayı: 3, 141–149. https://doi.org/10.54233/endourolbull-1883616

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Kaynakça (21)

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