Metastatik Olmayan Yüksek Riskli Prostat Kanserlerinde Radikal Prostatektomi Ameliyatı Öncesi Dosetaksel Kemoterapisi Uygulamasının Etkinliğinin Retrospektif Olarak Değerlendirilmesi
Özet
Currently, there is no standardized treatment procedure that has been reached a consensus on for high-risk prostate cancer (PC). Failure of neo-adjuvant androgen deprivation therapy (ADT) combined with Radical Prostatectomy (RP) in high-risk PC patients indicates the presence of castration-resistant cell clones in tumor during diagnosis, and brings up treatment options as systemic treatments which can also be effective on castration-resistant clones. Combining docetaxel chemotherapy, which has clearly demonstrated its efficacy on these clones in metastatic PC cases, with RP as a neoadjuvant therapy can be considered as a good treatment option. A total of 132 patients admitted to the Hacettepe University Faculty of Medicine Urology Department between the dates of 08.1987 - 08.2017 who were considered as high risk and underwent RP surgery according to the D'Amico Risk Staging System from non-metastatic prostate cancer patients were evaluated retrospectively. Data for 14 patients who underwent neo-adjuvant docetaxel chemotherapy before surgery and 28 patients who didn't undergo chemotherapy before surgery as they are selected by paired matching method were compared in terms of recurrence, survival and some other parameters. According to our findings, although it cannot be shown that NADK, which can be applied without serious adverse effects and generally well tolerated by patients, has a significant advange over the patients's Gleason scores (p=0,273), PSA values (p=0,145), pathologic stages (p=0,857), biochemical recurrence risk (p=0.383) and overall survival (p=0.527); it was determined that there was no increase in surgical complication rates, no prolongation of postoperative hospital stay (p=0.702), possible positive effects on malignant lymph node involvement, and prolongation of biochemical recurrence free survival (p=0.040).