Universität zu Köln

Herder, Jan, Boedefeld, Edith A. and Weissbach, Lothar (2020). Noninvasive treatment of organ-confined prostate cancer in elderly patients-results of the HAROW study. Urologe, 59 (4). S. 450 - 461. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

Background Noninvasive treatment options such as active surveillance (AS), watchful waiting (WW), and hormone deprivation therapy (HT) are particularly important in elderly patients with localized prostate cancer (PCa). Objectives We examine the use of these noninvasive treatment options in the everyday care in a cohort of patients >= 70 years old. Materials and methods In the HAROW study, the treatment of localized PCa under everyday conditions is investigated. The only inclusion criterion was newly diagnosed organ-confined PCa (<= cT2c). In AS, WW, and HT patients, we compared initial tumor and patient characteristics, follow-up examinations and changes of therapy. Results Of 457 patients >= 70 years, 210 chose AS, 160 HT, and 87 WW. Observation times were 6.3x202f;years (AS), 7.5x202f;years (HT), and 7.0x202f;years (WW). AS patients (73.2x202f;years) were younger than WW (76.0x202f;years) and HT patients (76.9x202f;years) and had a higher proportion of low-risk tumors (80%) versus WW (31%) and HT (19%). A change of therapy was observed in 47.1% of AS, 17.2% of WW and 13.1% of HT patients. Metastasis occurred in 1.0% of AS, 4.6% of WW, and 6.9% of HT patients. Overall survival was 94.3% for AS, 90.8% for WW and 81.9% for HT. Within the first 28.4 months, the mean number of PSA determinations did not differ between AS and WW (6.1 vs. 5.2; px202f;= 0.09); a rebiopsy was performed in 37.6% of AS, 11.4% of WW, and 17% of HT patients. Conclusions The allocation to curative and palliative strategies should be made according to patient and tumor characteristics by definition. Palliative procedures may represent concepts in older patients who initially chose a curative AS strategy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herder, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Boedefeld, Edith A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weissbach, Lothar UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-345400
DOI:	10.1007/s00120-020-01123-x
Journal or Publication Title:	Urologe
Volume:	59
Number:	4
Page Range:	S. 450 - 461
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0563
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACTIVE SURVEILLANCE; FOLLOW-UP; MEN; UPDATE; COHORT Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34540