| Popis: |
Background: Advanced forms of prostate cancer include a heterogeneous group of patients with an uneven prognosis. The lack of consensus on a precise definition of this group of patients prevents clinical decision-making and adequate patient counseling. Methods:In this retrospective study, we investigated a series of preoperative bio-clinical parameters (age, patient comorbidities, tumor clinical stage, serum PSA, preoperative Gleason score, the neutrophil / lymphocyte ratio value and hormonal profile of patients), in relation to some postoperative parameters (histopathological type of tumor, tumor pathological stage, postoperative Gleason score, extra-prostatic extension, positive margins, seminal vesicle invasion, perineural invasion, positive lymphadenopathy), in a group of 96 patients with radical prostatectomy (RP) between 2016 and 2020, for a better understanding of the behavior of the disease and adequate counseling of patients proposed for RP.Results: Of all the clinical and biological parameters analyzed, only the clinical T stage ≥ cT3a was statistically associated with an unfavorable pathological prognosis (p = 0.03). In the multivariate logistic regression model, the presence of a clinical tumor stage at clinical examination ≥ cT3a was associated with a 4.73-fold increase in the risk of unfavorable pathological prognosis. Moreover, the presence of a clinical T stage ≥ cT3a identifies with a sensitivity of 68.74% and a specificity of 65.71% patients with an unfavorable pathological prognosis. At the same time, the neutrophil / lymphocyte ratio (NLR) value was statistically significantly correlated only with the presence of secondary lymph node determinations (p = 0.006), and the serum level of dehydroepiandrostenedione was statistically significantly correlated with the presence of extra-prostatic extension (p = 0.05).Conclusions: The results obtained can have a significant impact in improving the knowledge of the pathogenesis of advanced forms of prostate cancer and in making clinical decisions, with immediate positive clinical effect (survival, quality of life) and socio-economic. |
