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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Can We Predict the Surgical Margin Positivity in Patients Treated with Radical Prostatectomy? A Multicenter Cohort of Turkish Association of Uro-Oncology(GALENOS YAYINCILIK, 2015-01-01) Bolat, Deniz; Eskicorapci, Saadettin; Karabulut, Erdem; Baltaci, Sumer; Yildirim, Asif; Sozen, Sinan; Ates, Ferhat; Sekerci, Cagri Akin; Kurtulus, Fatih; Dirim, Ayhan; Muezzioglu, Talha; Can, Cavit; Bozlu, Murat; Gemalmaz, Hakan; Ekici, Sinan; Ozen, Haluk; Turkeri, LeventObjective To analyze the parameters that predict the surgical margin positivity after radical prostatectomy for localized prostate cancer. Materials and Methods In this multicenter study, the data of 1607 consecutive patients undergoing radical prostatectomy for localized prostate cancer in 12 different clinics in Turkey between 1993-2011 were assessed. Patients who had neoadjuvant treatment were excluded. We assessed the relationship between potential predictive factors and surgical margin status after radical prostatectomy such as age, cancer characteristics, history of transurethral prostate resection, surgical experience and nerve-sparing technique by using univariate and multivariate Cox regression analyses and t test. Results The overall surgical margin positivity rate was 22.6\% (359 patients). In univariate analyses, preoperative prostate specific antigen level, clinical stage, biopsy Gleason score, percentage of tumor involvement per biopsy specimen, transurethral prostate resection history, surgical experience and nerve-sparing technique were significantly associated with positive surgical margin rate. In multivariate analyses, preoperative prostate specific antigen level (OR: 1.03, p=0.06), percentage of tumor involvement per biopsy specimen (OR: 7,14, p<0,001), surgical experience (OR: 2.35, p=0.011) and unilateral nerve-sparing technique (OR: 1.81, p=0.018) were independent predictive factors for surgical margin positivity. Conclusion Preoperative prostate specific antigen level, percentage of tumor involvement per biopsy specimen, surgical experience and nerve-sparing technique are the most important predictive factors of surgical margin positivity in patients undergoing radical prostatectomy for localized prostate cancer.Item Focal Therapy for Prostate Cancer: Current Status of HIFU(GALENOS YAYINCILIK, 2015-01-01) Ozkan, Tayyar Alp; Eskicorapci, SaadettinFirst choice treatment options for Prostate Cancer (PCa) are Radical Prostatectomy (RP), brachytherapy and pelvic radiation therapy in current guidelines. The aim of this paper was to review effectiveness and oncological results of high intensity frequency ultrasound treatment (HIFU) in patients with localized PCa. HIFU technology is based on a principle of focused ultrasound (US) waves in an area-sized 3x3x11 mm with a convex ultrasound probe. HIFU ablation was first successfully used in 1995 for 29 pre-radical prostatectomy patients with unilateral tumors (T2-T2b). This treatment option mostly used in Europe in US it has not been approved yet by Food and Drug Administration (FDA) and is used only for clinical trials. HIFU is a relatively new treatment method and 10 years of mid-term results for survival were began to emerge. HIFU biopsy success rates are about 80\%. There need to be more accurate and improved results in order to define it as a new definitive treatment option for prostate cancer. Although it has low success rates, it can be used for all risk groups (low, medium, high), it can be used as a rescue treatment after unsuccessful HIFU treatment, radiotherapy and brachytherapy.