Abstract | Stopa incidencije tumora prostate značajno raste nakon 50. godine života.
Etiološki se može okarakterizirati kao multifaktorijalna bolest sa nepredvidim
početkom. U suvremeno doba se napretkom dijagnostike karcinom sve više
dijagnosticira u ranijim stadijima što značajno poboljša učinkovitost liječenja te samim
time i preživljenje pacijenta uz sve veću kvalitetu života. Bolest je nerijetko
asimptomatska dok se u slučaju pojave simptomatologije najčešće javlja tegobe
vezane uz mokrenje, abnormalan nalaz digitorektalnog pregleda, eventualno
uvećanje limfnih čvorova te povećanje PSA. Ultrazvučno vođena biopsija prostate je
postala zlatni dijagnostički standard. Prilikom određivanja stadija bolesti se osim
navedenih metoda koristi slikvona dijagnostika u prvom redu MR koji imaju veću
osjetljivost u odnosu na CT zatim scintigrafija kosti, mjerenje ALP-a itd. Prema
procjeni liječnika odnosno kod sumnje na lokalno uznapredovalu bolest se može
napraviti i limfadenektomija što također može imati važan utjecaj na odluku o
modalitetu liječenja. U liječenju je teško odrediti zlatni standard. Modalitet ovisi
ponajprije o stadiju bolesti, dobi i preferencijama pacijenta. |
Abstract (english) | Incidence rate of a prostate tumor significantly increases after the age of 50.
Etiologically, it can be characterized as a multifactorial disease with an unpredictable
onset. In modern times, due to advancements in diagnostics, cancer is increasingly
diagnosed at earlier stages, which significantly improves the effectiveness of
treatment and thus, the patient's survival rate and quality of life. The disease is often
asymptomatic, but in case of symptomatic occurrence, complaints related to
urination, abnormal findings on a digital rectal examination, possible lymph node
enlargement, and increased PSA are the most common. Ultrasound-guided prostate
biopsy has become the gold diagnostic standard. In addition to the aforementioned
methods, imaging diagnostics are used to determine the disease stage, primarily MR,
which has a higher sensitivity compared to CT, then bone scintigraphy, measurement
of ALP, etc. Depending on the physician's assessment or suspicion of locally
advanced disease, lymphadenectomy can also be performed, which can have a
significant impact on the choice of treatment modality. It is difficult to determine the
gold standard for treatment. The modality primarily depends on the disease stage,
age, and patient preferences. |