Gleason skoru 3+3 prostat kanseri olan hastalarda radikal prostatektomi sonrası evre ilerlemesinin öngörülmesinde PI-RADS versiyon 2’nin rolü

Year 2020, Volume: 12 Issue: 3, 199 - 204, 31.12.2020

Sercan Yilmaz , Bahadır Topuz , Can Sicimli , Adem Emrah Coğuplugil , Engin Kaya , Murat Zor , Selahattin Bedir

Abstract

Amaç: Gleason skoru (GS), prostat kanserinin agresifitesinin öngörülmesinde kullanılan en önemli parametrelerdendir. TRUS prostat biyopsisindeki Gleason skoru ile radikal prostatektomi sonrası belirlenen Gleason skoru arasında uyumsuzluk saptanabilir. Bu çalışmada TRUS-bx sonrası GS 3+3 prostat kanseri olan hastalarda radikal prostatektomi sonrası GS evre ilerlemesini öngörmede mp-MRG özellikleri ve PI-RADS V2’nin önemini araştırmayı amaçladık.

Gereç ve Yöntemler: Hastanemizde Ocak 2016 ile Ocak 2020 yılları arasında TRUS-Bx sonrası GS 3+3 prostat kanseri saptanan ve robot yardımlı radikal prostatektomi (RARP) uygulanan hastaların verileri retrospektif olarak incelendi. Hastalar cerrahi sonrası evre ilerlemesi olan (Grup 1) ve olmayan (Grup 2) olmak üzere 2 gruba ayrıldı. Hastaların PSA seviyesi, hasta yaşı, prostat hacmi, PSA dansitesi, mp-MRG’deki indeks lezyon boyutu, PI-RADS versiyon 2 skorları değerlendirildi.

Bulgular: Çalışmaya dahil edilen toplam 43 hastanın ortalama yaşı 63.7±7.1 yıl idi. Yirmi beş hastada (%58.1) cerrahi sonrası evre ilerlemesi gözlenmiştir. Final patoloji raporuna göre prostat kanseri evre ilerlemesi gözlenen ve gözlenmeyen hasta grubunda yaş, PSA dansitesi ve PIRADS V2 skoru istatistiksel olarak anlamlı bulundu (p˂0.05). Evre ilerlemesi PI-RADS versiyon 2 skoru 4 olan 8 hasta ve 5 olan 5 hasta olmak üzere toplam 13 hastada gözlendi. mp-MRG indeks lezyon boyutu her iki grup arasında istatistiksel anlamlı fark olmasa da evre ilerlemesi olan grupta daha büyüktü (12.15±4.3 vs 15.69±7.6). mp-MRG’de prostat dışı yayılım gözlenmeyen hiçbir hastada evre ilerlemesi yokken, prostat dışına yayılım rapor edilen sadece 3 hastada evre ilerlemesi rapor edildi.

Sonuç: mp-MRG PIRADS v2 skorunun prostat kanseri evre ilerlemesinde önemli olduğunu saptadık.

Keywords

Gleason skoru, multiparametrik manyetik rezonans görüntüleme, PI-RADS skoru, prostat kanseri

The role of PI-RADS version 2 in predicting the stage progression after radical prostatectomy in patients with Gleason score 3+3 prostate cancer

Abstract

Objective: Gleason score (GS) is one of the most important parameters used in predicting the aggressiveness of prostate cancer. A discrepancy may be detected between the Gleason score in the TRUS prostate biopsy and the Gleason score determined after radical prostatectomy. In this study, we aimed to investigate the importance of mp-MRI features and PI-RADS V2 in predicting the progression of GS stage after radical prostatectomy in patients with GS 3+3 prostate cancer after TRUS-bx.

Material and Methods: The data of patients who were diagnosed with GS 3+3 prostate cancer after TRUS-Bx and underwent robot-assisted radical prostatectomy between January 2016 and January 2020 were retrospectively analyzed. The patients were divided into 2 groups as with progressive (Group 1) and not (Group 2) after surgery. The PSA level, patient age, prostate volume, PSA density, index lesion size on mp-MRI, PI-RADS version 2 scores of the patients were evaluated.

Results: The mean age of 43 patients included in the study was 63.7±7.1 years. Stage progression was observed in 25 patients (58.1%) after surgery. According to the final pathology report, age, PSA density and PIRADS V2 score were found to be statistically significant in the patient group with and without prostate cancer stage progression (p˂0.05). Stage progression was observed in a total of 13 patients, 8 patients with a PI-RADS version 2 score of 4 and 5 patients with a score of 5. Although the mp-MRI index lesion size was not statistically significant between the two groups, it was larger in the group with stage progression (12.15±4.3 vs 15.69±7.6). While there was no stage progression in any of the patients who did not show extra-prostate dissemination in mp-MRI, only 3 patients with extra-prostate spread were reported.

Conclusions: We found that the mp-MRI PIRADS v2 score is important in prostate cancer stage progression.

Keywords

gleason score, multi-parametric magnetic resonance imaging, PI-RADS score, prostate cancer

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