Prostat kanserinde aktif izlem hastalarının belirlenmesinde PSMA-pet ek katkı sağlar mı?
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Prostat kanseri erkeklerde akciğer kanserinin ardından en sık görülen 2. kanser türüdür. 2020 yılında dünyada ortalama 1,4 milyon yeni tanı alan prostat kanseri hastası bulunmaktadır (1,2). Günümüz teknolojisinde dahi erkekler arasında mortaliteye sebep olan en sık 3. kanser olarak varlığını sürdürmektedir (1). Aktif izlem, düşük risk grubunda bulunan prostat kanseri tanılı hastalara herhangi bir küratif tedavi vermeden hastaların düzenli aralıklarla takip edilmesidir. Aİ tedavisinin son zamanlarda giderek önem kazanması bu tedaviye dahil edilme kriterlerinin önemini arttırmaktadır. Fakat bazı dezavantajları mevcuttur. Bunlar Aİ'ye dahil edilme kriterlerinin net olarak belirlenememesi, hastalığın progresyon riskini öngörememe gibi durumlardır. Bizim amacımız da Aİ için hasta seçiminde PSMA-PET/BT'den faydalanarak olası yeni endikasyonlar bulmak, Aİ'ye dahil edilecek hastaların seçiminde PSMA-PET/BT'nin katkısını araştırmaktır. 2017-2022 yılları arasında radikal prostatektomi ameliyatı olmuş hastalardan kriterlerimize uyan toplam 44 hasta çalışmaya dahil edildi. Biyopsi patolojilerinde GS (3+3) olan bu 44 hasta cerrahi sonrası patolojilerine göre GS (3+3) olarak kalanlar ve GS>(3+3) olarak değişenler olmak üzere 2 gruba ayrıldı. Bu iki grup arasındaki kliniko-demografik veriler ve çekilen görüntülerden elde edilen parametreler karşılaştırıldı. Bu parametreler ortalama tümör hacmi (MTV), ortalama tümör hacmi/prostat hacmi, prostatın housefield üniti, seminal vezikül ve lenf nodu tutulumu, prostatın SUVmax değeri, dalak ve karaciğerin SUVmax değerleri, prostat SUVmax değerlerinin dalak ve karaciğere oranları ve tümör lokalizasyonları olarak belirlendi. Bu 2 grup arasında bahsedilen parametreler açısından istatistiksel anlamlı farklılık izlenmedi. Yeterli sayıda hasta popülasyonunu sağlayamadığımızı bu sebeple istatistiksel anlamlı verilere ulaşamadığımızı düşünüyoruz. Daha geniş popülasyonlu ve kapsamlı çalışmaların bu konuda anlamlı sonuçlara ulaşacağını ve Aİ'ye hasta seçme konusunda PSMA-PET/BT'nin katkı sağlayacağını ve dahil edilme kritelerinin genişletileceğini düşünüyoruz.
Prostate cancer is the second most common type of cancer in men, after lung cancer. In 2020, there are approximately 1.4 million newly diagnosed prostate cancer patients in the world. Even with today's technology, it continues to exist as the 3rd most common cancer causing mortality among men. Active surveillance is the regular follow-up of patients with prostate cancer, who are in the low-risk group, without giving any curative treatment. The increasing importance of AS treatment increases the importance of inclusion criteria in this treatment. But there are some disadvantages of this treatment. These are situations such as the inability to clearly determine the criteria for inclusion in AS, and the inability to predict the risk of progression of the disease. Our aim is to find possible new indications by using PSMA-PET/CT in patient selection for AS, and to investigate the contribution of PSMA-PET/CT in the selection of patients to be included in AS. A total of 44 patients who met our criteria, who had undergone radical prostatectomy between 2017 and 2022, were included in the study. These 44 patients with GS (3+3) in biopsy pathologies were divided into 2 groups according to their post-surgical pathologies as those who remained as GS (3+3) and those who changed as GS>(3+3). The clinico-demographic data and the parameters obtained from PSMA-PET/CT images taken between these two groups were compared. These parameters were determined as mean tumor volume (MTV), mean tumor volume/prostate volume, housefield unit of prostate, seminal vesicle and lymph node involvement, SUVmax value of prostate, SUVmax values of spleen and liver, ratio of prostate SUVmax values to spleen and liver, and tumor localizations. No statistically significant difference was observed between these 2 groups in terms of the mentioned parameters. We think that we could not provide a sufficient number of patient population, therefore we could not reach statistically significant data. It seems that larger population and comprehensive studies will reach meaningful results in this regard, PSMA-PET/CT will contribute to the selection of patients for AS and inclusion criteria will be expanded.
Prostate cancer is the second most common type of cancer in men, after lung cancer. In 2020, there are approximately 1.4 million newly diagnosed prostate cancer patients in the world. Even with today's technology, it continues to exist as the 3rd most common cancer causing mortality among men. Active surveillance is the regular follow-up of patients with prostate cancer, who are in the low-risk group, without giving any curative treatment. The increasing importance of AS treatment increases the importance of inclusion criteria in this treatment. But there are some disadvantages of this treatment. These are situations such as the inability to clearly determine the criteria for inclusion in AS, and the inability to predict the risk of progression of the disease. Our aim is to find possible new indications by using PSMA-PET/CT in patient selection for AS, and to investigate the contribution of PSMA-PET/CT in the selection of patients to be included in AS. A total of 44 patients who met our criteria, who had undergone radical prostatectomy between 2017 and 2022, were included in the study. These 44 patients with GS (3+3) in biopsy pathologies were divided into 2 groups according to their post-surgical pathologies as those who remained as GS (3+3) and those who changed as GS>(3+3). The clinico-demographic data and the parameters obtained from PSMA-PET/CT images taken between these two groups were compared. These parameters were determined as mean tumor volume (MTV), mean tumor volume/prostate volume, housefield unit of prostate, seminal vesicle and lymph node involvement, SUVmax value of prostate, SUVmax values of spleen and liver, ratio of prostate SUVmax values to spleen and liver, and tumor localizations. No statistically significant difference was observed between these 2 groups in terms of the mentioned parameters. We think that we could not provide a sufficient number of patient population, therefore we could not reach statistically significant data. It seems that larger population and comprehensive studies will reach meaningful results in this regard, PSMA-PET/CT will contribute to the selection of patients for AS and inclusion criteria will be expanded.
Açıklama
Tıp Fakültesi, Üroloji Ana Bilim Dalı
Anahtar Kelimeler
Üroloji, Urology
