Προσδιορισμός και αντιμετώπιση ασθενών με ιστοπαθολογικά ευρήματα υψηλού κινδύνου μετά από ριζική προστατεκτομή

Στέφανος Αδάμης, Ιωάννης Βαρκαράκης

Abstract


Ευρήματα υψηλού κινδύνου στο παρασκεύασμα της ριζικής προστατεκτομής παρατηρείται στο 38-52% των περιπτώσεων. Ως τέτοια ευρήματα θεωρούνται η εξωπροστατική επέκταση της νόσου, τα θετικά χειρουργικά όρια και η διήθηση των σπερματοδόχων κύστεων, τα οποία είναι συνυφασμένα με σημαντικό κίνδυνο υποτροπής και εξέλιξης του προστατικού καρκίνου. Η αντιμετώπιση των ασθενών αυτών είναι πολύπλοκη. Αν και τεκμηριωμένα στοιχεία επιπέδου 1 (level 1 evidence) υποστηρίζουν την ευρεία εφαρμογή της επικουρικής ακτινοθεραπείας, υπάρχουν απόψεις που είναι υπέρ μιας πιο επιλεκτικής θεραπευτικής προσπέλασης. Στην παρούσα ανασκόπηση παρουσιάζονται όλες οι σύγχρονες θεραπευτικές μέθοδοι για την αντιμετώπιση του τοπικά προχωρημένου καρκίνου του προστάτη και αναλύονται τα αποτελέσματα διαφόρων μελετών σχετικά με την εφαρμογή τους.

Keywords


ΤΟΠΙΚΑ ΠΡΟΧΩΡΗΜΕΝΟΣ ΚΑΡΚΙΝΟΣ ΤΟΥ ΠΡΟΣΤΑΤΗ; ΡΙζΙΚΗ ΠΡΟΣΤΑΤΕΚΤΟΜΗ; ΕΠΙΚΟΥΡΙΚΗ ΑΚΤΙΝΟΘΕΡΑΠΕΙΑ; ΔΙΑΣΩΣΤΙΚΗ ΑΚΤΙΝΟΘΕΡΑΠΕΙΑ; ΟΡΜΟΝΙΚΗ ΘΕΡΑΠΕΙΑ

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DOI: http://dx.doi.org/10.19264/hj.v25i1.1