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master's thesis
Pozitivitet zdjeličnih limfnih čvorova kod radikalne prostatektomije

Ivica Paulić (2016)
Metadata
TitlePozitivitet zdjeličnih limfnih čvorova kod radikalne prostatektomije
AuthorIvica Paulić
Mentor(s)Josip Španjol (thesis advisor)
Abstract
Karcinom prostate postao je zbog svoje učestalosti veliki javnozdravstveni problem širom svijeta, a posebno u razvijenim zemljama gdje se bilježi porast udjela starijeg stanovništva. Drugi je najčešde dijagnosticirani karcinom kod muškaraca nakon karcinoma pluda, bronha i traheje. U dijagnostici karcinoma prostate i određivanju njegove proširenosti, osim kliničkih (DRP, vrijednost PSA) i radioloških (CT, MR, scintigrafija skeleta) metoda, važnu ulogu ima zdjelična limfadenektomija koja je uobičajeni segment radikalnog operativnog zahvata za lokalno ograničenu bolest. Na temelju patološke analize odstranjenih limfnih čvorova postavlja se procjena N stadija. Stoga, zdjelična limfadenektomija predstavlja zlatni standard za detekciju tumorskih presadnica u zdjeličnim limfnim čvorovima, a u okolnostima minimalne lokalne proširenosti karcinoma može biti kurativnog karaktera i poboljšati preživljenje. Informacije dobivene ovim postupkom ključne su za procjenu progresije bolesti i planiranje adjuvantne terapije, ako se pokaže potrebnom. No, s obzirom da ne postoji uniforman rizik za limfonodalnu invaziju, izvođenje zdjelične limfadenektomije se prema smjernicama preporučuje u skupini pacijenata sa nepovoljnim preoperativnim nalazom, kao što je vrijednost serumske koncentracije PSA > 10 ng/ml, klinički stadij > T1c te bioptički Gleasonov zbroj > 6. Također, ako je kod pacijenata s karcinomom prostate indicirana zdjelična limfadenektomija, preporučuje se izvođenje proširene varijante. Proširena zdjelična limfadenektomija značajno povedava točnost određivanja N-stadija smanjivanjem stope lažno negativnih nalaza povezanih sa ograničenom limfadenektomijom
KeywordsProstate cancer radical prostatectomy
Committee MembersRomano Oguić (committee chairperson)
Alen Protić (committee member)
Dean Markić (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za kirurgiju
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Urology
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
Prostate cancer became a major public health problem worldwide due to increased incidence, especially in developed countries where higher rates of older population are recorded. It is the second most common cancer in men following lung, bronchus and trachea cancer. In detection and staging of prostate cancer, apart from clinical (DRE, PSA level) and imaging (CT, MR, bone scan) methods, dissection of pelvic lymph nodes has an important role as an usual segment of radical operative procedure for locally confined disease. Based on pathological analysis of dissected lymph nodes, N stage assessment is made. Therefore, pelvic lymphadenectomy represents a golden standard for detection of pelvic lymph node metastases, and in the setting of minimal regional spread can also provide therapeutic benefit and have an impact on reduction of CaP-specific death. Information provided with this treatment are key for assessment of disease progression and planning of adjuvant therapy, if it`s needed. However, considering that uniform risk for positive lymph nodes does not exist, lymph nodes dissection, according to Guidelines, is recommended in group of patients with unfavourable preoperative findings, such as serum PSA level > 10 ng/ml, clinical stage > T1c and biopsy Gleason score > 6. Also, if the pelvic lymph node dissection is indicated in patients with prostate cancer, it is recommended to be expanded one. Expanded pelvic lymph node dissection significantly increases the nodal staging accuracy by decreasing the rate of false negative findings associated with limited dissection
Parallel keywords (Croatian)Karcinom prostate radikalna prostatektomija
Resource typetext
Access conditionAccess restricted to higher education institution's students and staff
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:499975
CommitterBosa Licul