Universität zu Köln

Weissbach, Lothar, Boedefeld, Edith A. and Herden, Jan (2021). Active surveillance-much safety, little recruitment Is it possible to extend the indication for intermediate-risk prostate cancer? Urologe, 60 (10). S. 1304 - 1313. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

Background In contrast to North America or Sweden, active surveillance (AS) has not yet become established in our country for suitable prostate carcinomas (PCa). The strict entry criteria specified by the guideline are not likely to improve the acceptance in the near future. In early detection, prostate-specific antigen (PSA) testing leads to high numbers of overtreatment. There are various reasons for the continued preference for radical surgery. Objectives The goal is to examine whether the heterogeneous group with intermediate-risk PCa contains tumors that may be eligible for AS. Materials and methods In the HAROW trial, 52 AS patients with differently defined intermediate-risk PCa were followed for a median of 85.6 months. Oncologic outcomes are reported. Results Sixteen (30%) patients had a tumor of cT2b category, 21 (40%) had a Gleason score 3 + 4, 7 (14%) had >= 3 positive biopsy cores, 21 (40%) had a PSA >10 ng/ml, and 22 (42%) had a PSA density >0.2 ng/ml(2). Carcinoma-specific and metastasis-free survival were 100% and 96%, respectively. Thirty four patients discontinued AS in favor of invasive treatment, and an additional eight men maintained a noninvasive approach by switching to watchful waiting. Conclusions Efforts are under way to specify the criteria for patients with intermediate-risk PCa who may be eligible for AS. Tumors of cT2 category could be grouped together. The Gleason 4 fraction needs to be quantified because it determines the prognosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weissbach, Lothar UNSPECIFIED UNSPECIFIED UNSPECIFIED Boedefeld, Edith A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herden, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-571158
DOI:	10.1007/s00120-021-01525-5
Journal or Publication Title:	Urologe
Volume:	60
Number:	10
Page Range:	S. 1304 - 1313
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0563
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OUTCOMES; MEN; GUIDELINES; DIAGNOSIS; CRITERIA; ANTIGEN; GRADE Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57115