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Dissertations / Theses on the topic 'Prostatakrebs'

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Published: 4 June 2021
Last updated: 30 January 2023

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1

Schmid, Hans-Peter. "The clinically organ-confined adenocarcinoma of the prostate : natural history, selection criteria for radical prostatectomy and prognostic factors based on long-term follow-up /." Darmstadt : Steinkopff, 1994. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Bachmann, Natascha. "Molekulargenetische Untersuchungen zum EZH2-Gen beim Prostatakarzinom." [S.l. : s.n.], 2006. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-56332.

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3

Gemeinhardt, Ole. "Funktionelle Bildgebung der Vaskularisation und Perfusion des Prostatakarzinoms mit dynamischer MRT : Korrelation mit morphometrischen Parametern /." Berlin : Mbv, 2008. http://d-nb.info/990627349/04.

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4

Cedl, Thorsten. "Histopathologischer Vergleich von Prostatastanzbiopsien und durch transurethrale Resektion der Prostata (TURP) gewonnenem Gewebe bei Patienten mit lokoregionärem Prostatakarzinom : eine retrospektive Studie." kostenfrei, 2008. http://www.opus-bayern.de/uni-regensburg/volltexte/2009/1252/.

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5

Hübner, Stephanie Carolin. "Lokale Kontrolle und Lebensqualität nach normdosierter Low Dose Rate-Brachytherapie des Prostatakarzinoms." [S.l. : s.n.], 2008. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-66342.

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6

Kurtz, Florian. "Kopplungsanalyse auf Chromosom 20 bei familiärem Prostatakarzinom." [S.l. : s.n.], 2006. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-58868.

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7

Helbig, Sina. "Trends der radioonkologischen Behandlungsstrategien bei lokoregionär begrenzten Prostatakarzinom in der Bundesrepublik Deutschland /." Berlin : Grauer Verl, 2006. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=015464752&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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8

Martin, Ann Christine. "Einfluss von klinischen Parametern auf die Kopplung zu Susceptibilitätsloci beim familiären Prostatakarzinom in Deutschland." [S.l. : s.n.], 2007. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-59187.

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9

Scheipers, Ulrich. "Sonohistology methods and systems for ultrasonic tissue characterization based on a multifeature approach and fuzzy inference systems." Berlin Logos-Verl, 2004. http://deposit.ddb.de/cgi-bin/dokserv?id=2655720&prov=M&dok_var=1&dok_ext=htm.

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10

Schlegel, Marc Peter. "Analyse eines Kombinationsbiomarkers mit prädiktivem Wert beim Prostatakarzinom." [S.l. : s.n.], 2008. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-66038.

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11

Zieher, Heike. "Untersuchungen des Einflusses von Inhibitoren der Angiogenese und ionisierender Bestrahlung auf das Wachstumsverhalten solider Tumoren in vivo." Giessen : VVB Laufersweiler, 2007. http://geb.uni-giessen.de/geb/volltexte/2007/4714/index.html.

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12

Ferstl, Florian. "Salvage-Strahlentherapie nach der Behandlung mit hoch intensivem fokussiertem Ultraschall (HIFU) beim lokal begrenzten Prostatakarzinom : erste klinische Resultate." kostenfrei, 2008. http://www.opus-bayern.de/uni-regensburg/volltexte/2008/1093/.

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13

Wollenweber, Frank Arne. "Stellenwert der 11C-Cholin PET/CT Untersuchung in der Rezidivdiagnostik des Prostatakarzinomes." [S.l. : s.n.], 2006. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-55945.

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14

Grunz, Jan-Peter [Verfasser], Hermann [Gutachter] Faller, and Oorschot Birgitt [Gutachter] van. "Benefit Finding von Patienten mit Prostatakrebs im Behandlungsverlauf / Jan-Peter Grunz ; Gutachter: Hermann Faller, Birgitt van Oorschot." Würzburg : Universität Würzburg, 2018. http://d-nb.info/1160877181/34.

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15

Grell, Jan [Verfasser]. "Eine aberrante Expression des Mikrotubuli-assoziierten Proteins Tau ist ein unabhängiger prognostischer Marker bei Prostatakrebs / Jan Grell." Hamburg : Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky, 2020. http://d-nb.info/1236695283/34.

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16

Hobusch, Dirk. "Prostatakarzinomvorsorgeuntersuchung inklusive PSA-Screening in einer urologischen Praxis zwischen 1997 und 2006." Duisburg Köln WiKu, 2008. http://d-nb.info/987971921/04.

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17

Ospina-Klinck, Daniel [Verfasser], and Guido [Akademischer Betreuer] Sauter. "Zusammenhang der NY-ESO-1 Expression zur TMPRSS2:ERG-Genfusion beim Prostatakrebs / Daniel Ospina-Klinck ; Betreuer: Guido Sauter." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2017. http://d-nb.info/112415535X/34.

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18

Schleich, Sonja. "Nichtsteroidale Antiandrogene natürlichen und synthetischen Ursprungs zur Behandlung des Prostatakarzinoms." Marburg : Görich und Weiershäuser, 2005. http://archiv.ub.uni-marburg.de/diss/z2005/0223/.

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19

Schönle, Nicole [Verfasser], Vratislav [Akademischer Betreuer] Strnad, and Vratislav [Gutachter] Strnad. "Langzeitergebnisse einer protokollbasierten ultraschallgesteuerten Salvage-Brachytherapie als Wiederbestrahlung bei lokal rezidivierendem Prostatakrebs / Nicole Schönle ; Gutachter: Vratislav Strnad ; Betreuer: Vratislav Strnad." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2021. http://d-nb.info/122771100X/34.

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20

Walther, Alexia Katharina [Verfasser], Kathleen [Akademischer Betreuer] [Gutachter] Herkommer, and Jürgen Erich [Gutachter] Gschwend. "Stadienmigration und Veränderung von Tumoreigenschaften bei Patienten mit Prostatakrebs nach radikaler Prostatektomie 1998-2012 / Alexia Katharina Walther. Betreuer: Kathleen Herkommer. Gutachter: Kathleen Herkommer ; Jürgen Erich Gschwend." München : Universitätsbibliothek der TU München, 2016. http://d-nb.info/1102355461/34.

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Walther, Alexia Katharina Verfasser], Kathleen [Akademischer Betreuer] [Gutachter] Herkommer, and Jürgen E. [Gutachter] [Gschwend. "Stadienmigration und Veränderung von Tumoreigenschaften bei Patienten mit Prostatakrebs nach radikaler Prostatektomie 1998-2012 / Alexia Katharina Walther. Betreuer: Kathleen Herkommer. Gutachter: Kathleen Herkommer ; Jürgen Erich Gschwend." München : Universitätsbibliothek der TU München, 2016. http://nbn-resolving.de/urn:nbn:de:bvb:91-diss-20160303-1251731-1-6.

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22

Kushner, Julien Christian [Verfasser], Markus [Gutachter] Porsch, and Thorsten [Gutachter] Schlomm. "Die interdisziplinäre Sprechstunde für Prostatakrebs an der Charité Berlin : Betrachtung der Gründungsphase aus Sicht der Leitlinienrealität 2019/2020 / Julien Christian Kushner ; Gutachter: Markus Porsch, Thorsten Schlomm." Magdeburg : Universitätsbibliothek Otto-von-Guericke-Universität, 2020. http://d-nb.info/1237047447/34.

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23

Wirth, Manfred P., and Oliver W. Hakenberg. "Brachytherapy for Prostate Cancer." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133901.

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24

Krenn, Alexandra [Verfasser], Kathleen [Akademischer Betreuer] Herkommer, Kathleen [Gutachter] Herkommer, and Andreas [Gutachter] Dinkel. "Einflussfaktoren auf das Interesse an einem Prostatakrebs-Gentest: Befragung 45-jähriger Männer im Rahmen der PROBASE Studie / Alexandra Krenn ; Gutachter: Kathleen Herkommer, Andreas Dinkel ; Betreuer: Kathleen Herkommer." München : Universitätsbibliothek der TU München, 2019. http://d-nb.info/121217805X/34.

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25

Mechow, Stefanie von [Verfasser]. "Rückkehr ins Erwerbsleben nach offener retropubischer und roboterassistierter radikaler Prostatektomie : Retrospektive Studie an 1415 Patienten der Martini-Klinik Prostatakrebs- Zentrum in den Jahren 2012-2016 / Stefanie von Mechow." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1175646237/34.

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26

Wirth, Manfred P., and Oliver W. Hakenberg. "Brachytherapy for Prostate Cancer." Karger, 1999. https://tud.qucosa.de/id/qucosa%3A27547.

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27

Hammer, Paul. "Transkriptomweite Untersuchungen von Prostata-Krebszelllinien im Kontext medizinischer Strahlentherapie." Phd thesis, Universität Potsdam, 2012. http://opus.kobv.de/ubp/volltexte/2013/6319/.

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Die Strahlentherapie ist neben der Chemotherapie und einer operativen Entfernung die stärkste Waffe für die Bekämpfung bösartiger Tumore in der Krebsmedizin. Nach Herz-Kreislauf-Erkrankungen ist Krebs die zweithäufigste Todesursache in der westlichen Welt, wobei Prostatakrebs heutzutage die häufigste, männliche Krebserkrankung darstellt. Trotz technologischer Fortschritte der radiologischen Verfahren kann es noch viele Jahre nach einer Radiotherapie zu einem Rezidiv kommen, was zum Teil auf die hohe Resistenzfähigkeit einzelner, entarteter Zellen des lokal vorkommenden Tumors zurückgeführt werden kann. Obwohl die moderne Strahlenbiologie viele Aspekte der Resistenzmechanismen näher beleuchtet hat, bleiben Fragestellungen, speziell über das zeitliche Ansprechen eines Tumors auf ionisierende Strahlung, größtenteils unbeantwortet, da systemweite Untersuchungen nur begrenzt vorliegen. Als Zellmodelle wurden vier Prostata-Krebszelllinien (PC3, DuCaP, DU-145, RWPE-1) mit unterschiedlichen Strahlungsempfindlichkeiten kultiviert und auf ihre Überlebensfähigkeit nach ionisierender Bestrahlung durch einen Trypanblau- und MTT-Vitalitätstest geprüft. Die proliferative Kapazität wurde mit einem Koloniebildungstest bestimmt. Die PC3 Zelllinie, als Strahlungsresistente, und die DuCaP Zelllinie, als Strahlungssensitive, zeigten dabei die größten Differenzen bezüglich der Strahlungsempfindlichkeit. Auf Grundlage dieser Ergebnisse wurden die beiden Zelllinien ausgewählt, um anhand ihrer transkriptomweiten Genexpressionen, eine Identifizierung potentieller Marker für die Prognose der Effizienz einer Strahlentherapie zu ermöglichen. Weiterhin wurde mit der PC3 Zelllinie ein Zeitreihenexperiment durchgeführt, wobei zu 8 verschiedenen Zeitpunkten nach Bestrahlung mit 1 Gy die mRNA mittels einer Hochdurchsatz-Sequenzierung quantifiziert wurde, um das dynamisch zeitversetzte Genexpressionsverhalten auf Resistenzmechanismen untersuchen zu können. Durch das Setzen eines Fold Change Grenzwertes in Verbindung mit einem P-Wert < 0,01 konnten aus 10.966 aktiven Genen 730 signifikant differentiell exprimierte Gene bestimmt werden, von denen 305 stärker in der PC3 und 425 stärker in der DuCaP Zelllinie exprimiert werden. Innerhalb dieser 730 Gene sind viele stressassoziierte Gene wiederzufinden, wie bspw. die beiden Transmembranproteingene CA9 und CA12. Durch Berechnung eines Netzwerk-Scores konnten aus den GO- und KEGG-Datenbanken interessante Kategorien und Netzwerke abgeleitet werden, wobei insbesondere die GO-Kategorien Aldehyd-Dehydrogenase [NAD(P)+] Aktivität (GO:0004030) und der KEGG-Stoffwechselweg der O-Glykan Biosynthese (hsa00512) als relevante Netzwerke auffällig wurden. Durch eine weitere Interaktionsanalyse konnten zwei vielversprechende Netzwerke mit den Transkriptionsfaktoren JUN und FOS als zentrale Elemente identifiziert werden. Zum besseren Verständnis des dynamisch zeitversetzten Ansprechens der strahlungsresistenten PC3 Zelllinie auf ionisierende Strahlung, konnten anhand der 10.840 exprimierten Gene und ihrer Expressionsprofile über 8 Zeitpunkte interessante Einblicke erzielt werden. Während es innerhalb von 30 min (00:00 - 00:30) nach Bestrahlung zu einer schnellen Runterregulierung der globalen Genexpression kommt, folgen in den drei darauffolgenden Zeitabschnitten (00:30 - 01:03; 01:03 - 02:12; 02:12 - 04:38) spezifische Expressionserhöhungen, die eine Aktivierung schützender Netzwerke, wie die Hochregulierung der DNA-Reparatursysteme oder die Arretierung des Zellzyklus, auslösen. In den abschließenden drei Zeitbereichen (04:38 - 09:43; 09:43 - 20:25; 20:25 - 42:35) liegt wiederum eine Ausgewogenheit zwischen Induzierung und Supprimierung vor, wobei die absoluten Genexpressionsveränderungen ansteigen. Beim Vergleich der Genexpressionen kurz vor der Bestrahlung mit dem letzten Zeitpunkt (00:00 - 42:53) liegen mit 2.670 die meisten verändert exprimierten Gene vor, was einer massiven, systemweiten Genexpressionsänderung entspricht. Signalwege wie die ATM-Regulierung des Zellzyklus und der Apoptose, des NRF2-Signalwegs nach oxidativer Stresseinwirkung und die DNA-Reparaturmechanismen der homologen Rekombination, des nicht-homologen End Joinings, der MisMatch-, der Basen-Exzision- und der Strang-Exzision-Reparatur spielen bei der zellulären Antwort eine tragende Rolle. Äußerst interessant sind weiterhin die hohen Aktivitäten RNA-gesteuerter Ereignisse, insbesondere von small nucleolar RNAs und Pseudouridin-Prozessen. Demnach scheinen diese RNA-modifizierenden Netzwerke einen bisher unbekannten funktionalen und schützenden Einfluss auf das Zellüberleben nach ionisierender Bestrahlung zu haben. All diese schützenden Netzwerke mit ihren zeitspezifischen Interaktionen sind essentiell für das Zellüberleben nach Einwirkung von oxidativem Stress und zeigen ein komplexes aber im Einklang befindliches Zusammenspiel vieler Einzelkomponenten zu einem systemweit ablaufenden Programm.
The use of radiotherapy in addition to chemotherapy and surgical removal is the most powerful instrument in the fight against malignant tumors in cancer medicine. After cardiovascular diseases, cancer is the second leading cause of death in the western world, in which prostate cancer is the most frequent male cancer. Despite continuous technological improvements in radiological instruments and prognosis, it may occur a recurrence up to many years after radiotherapy due to a high resistance capability of individual malignant cells of the locally occurring tumor. Although modern radiation biology has studied many aspects of the resistance mechanisms, questions are largely unanswered especially in regards to prognostic terms and time response of tumor cells to ionizing radiation. As cellular models four prostate cancer cell lines with different radiation sensitivities (PC3, DuCaP, DU-145, RWPE-1) were cultured and tested for their ability to survive after exposure to ionizing radiation by a trypane blue and MTT viability assay. The proliferative capacity of the four cell lines was determined using a colony formation assay. The PC3 cell line (radiation-resistant) and the DuCaP cell line (radiation-sensitive) showed the maximal differences in terms of radiation sensitivity. Based on these results the two cell lines were selected to allow identification of potential prognostic marker for predicting the effectiveness of radiation therapy via their transcriptome-wide gene expression. Furthermore, a time series experiment with the radiation-resistant PC3 cell line was performed. At 8 different time points, during the period from 00:00 - 42:53 (hh:mm) after exposure with 1 Gy, the mRNA was quantified by next generation sequencing to investigate the dynamic behavior of time-delayed gene expression and to discover resistance mechanisms. Of 10,966 expressed genes 730 were significant differentially expressed, determined by setting a fold change threshold in conjunction with a P-value < 0.01. Of those 305 were more strongly expressed in PC3 cell line and 425 were more strongly expressed in the DuCaP cell line. Within these 730 genes many known stress-associated genes could be found, such as the two trans-membrane protein genes CA9 and CA12, which are associated with increased radiation resistance. By calculating a network score interesting networks were derived by the GO and KEGG databases. In particular the GO categories aldehyde dehydrogenase [NAD(P)+] activity (GO:0004030) as well as the KEGG pathway of O-glycan biosynthesis (hsa00512) seems to be remarkably relevant. An interaction analysis revealed two promising networks with the transcription factors JUN and FOS as central elements. High expression of the JUN network would be stand as indicator for radiation resistance whereas a high expression of the FOS network is equated with radiation sensitivity. Interesting insights could be achieved by analyzing the 10,840 expressed genes of the PC3 cell line and its expression profile over the 8 time points. Shortly after irradiation (00:00 - 00:30) a transcriptome-wide down-regulation occurred, within the next three, short time periods (00:30 - 01:03; 01:03 - 02:12; 02:12 - 04:38) a predominant increase of gene expression and the activation of protective networks followed, such as the up-regulation of DNA repair systems or the arresting of cell cycle. In the ensuing three time periods (4:38 - 09:43; 09:43 - 20:25; 20:25 - 42:35) a balance between gene induction and suppression was present and the absolute gene expression change was increased. When comparing the gene expression prior to irradiation with the last time point (00:00 - 42:53) 2,670 genes were differentially expressed, suggesting a massive and system-wide change of gene expression. Signaling pathways such as the ATM-regulated cell cycle and apoptosis, the Nrf2 pathway after oxidative stress exposure, the DNA repair mechanisms of homologous recombination, the non-homologous end joining, the mismatch repair, base-excision repair and strand-excision repair play a major role. Very interesting are the high activity of RNA-driven events, especially activities of small nucleolar RNAs and pseudouridine processes. This suggests that these RNA-modifying networks could have a hitherto unknown functional and protective effect on cell survival after exposure to ionizing radiation. All these protective networks and their time-specific interactions are essential for the survival of cells after exposure to oxidative stress and show a complex but consistent interaction of many individual components to a system-wide running program.
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28

Meyer, Franziska von [Verfasser], Kathleen [Akademischer Betreuer] Herkommer, Kathleen [Gutachter] Herkommer, and Jürgen E. [Gutachter] Gschwend. "Risikowahrnehmung und Besorgnis an Prostatakrebs zu erkranken in Abhängigkeit von einer familiären Vorbelastung und soziodemographischen Daten bei 45-jährigen Männern in Deutschland / Franziska von Meyer ; Gutachter: Kathleen Herkommer, Jürgen E. Gschwend ; Betreuer: Kathleen Herkommer." München : Universitätsbibliothek der TU München, 2018. http://d-nb.info/1171425287/34.

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29

Meyer, Franziska von Verfasser], Kathleen [Akademischer Betreuer] [Herkommer, Kathleen [Gutachter] Herkommer, and Jürgen E. [Gutachter] Gschwend. "Risikowahrnehmung und Besorgnis an Prostatakrebs zu erkranken in Abhängigkeit von einer familiären Vorbelastung und soziodemographischen Daten bei 45-jährigen Männern in Deutschland / Franziska von Meyer ; Gutachter: Kathleen Herkommer, Jürgen E. Gschwend ; Betreuer: Kathleen Herkommer." München : Universitätsbibliothek der TU München, 2018. http://nbn-resolving.de/urn:nbn:de:bvb:91-diss-20181002-1379386-1-6.

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30

Wirth, Manfred. "Delaying/Reducing the Risk of Clinical Tumour Progression after Primary Curative Procedures." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134720.

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The advent of prostate-specific antigen (PSA) testing and increased patient awareness has led to patients being diagnosed with prostate cancer at an earlier stage and a younger age than previously. Adjuvant hormonal therapy to radiotherapy or prostatectomy has been shown to reduce the risk of tumour progression, and in some studies survival benefits have been demonstrated. The non-steroidal antiandrogen bicalutamide (‘Casodex’) has undergone extensive evaluation and is currently undergoing clinical trials as immediate therapy, either alone or as adjuvant to treatment of curative intent in patients with localized or locally advanced disease. Data from the first analysis of one of the studies in the Early Prostate Cancer (EPC) programme involving 3,603 patients have shown that, after a median follow-up of 2.6 years, the risk of prostate cancer progression was significantly reduced (by 43%) in patients receiving bicalutamide 150 mg compared with those receiving standard care alone (HR 0.57; 95% CI 0.48, 0.69; p ≪ 0.0001). The risk of PSA progression was also significantly reduced (by 63%). At this stage the survival data are still immature. Side effects of bicalutamide were mostly gynaecomastia and breast pain, which is consistent with its pharmacology. Overall withdrawal rates were similar in the bicalutamide 150 mg and standard care alone groups. In the bicalutamide 150 mg group, withdrawals were mainly due to side effects, whereas in the group receiving standard care alone, withdrawals were mainly due to disease progression. The programme is ongoing, and survival data are awaited
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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31

Wirth, Manfred P., and Michael Fröhner. "Perspectives in Adjuvant Treatment of Prostate Cancer." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133839.

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32

Manseck, Andreas, Michael Fröhner, Sven Oehlschläger, Oliver W. Hakenberg, Katrin Friedrich, Franz Theissig, and Manfred P. Wirth. "Is Systematic Sextant Biopsy Suitable for the Detection of Clinically Significant Prostate Cancer?" Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133885.

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Background: The optimal extent of the prostate biopsy remains controversial. There is a need to avoid detection of insignificant cancer but not to miss significant and curable tumors. In alternative treatments of prostate cancer, repeated sextant biopsies are used to estimate the response. The aim of this study was to investigate the reliability of a repeated systematic sextant biopsy as the standard biopsy technique in patients with significant tumors which are being considered for curative treatment. Methods: Systematic sextant biopsy was performed in vitro in 92 radical prostatectomy specimens. Of these patients, 81 (88.0%) had palpable lesions. Results: Of the 92 investigated patients, 70 (76.1%) had potentially curable pT2-3pN0 prostate cancers. In these patients, the cancer was detected only in 72.9% of cases by a repeated in vitro biopsy. In the pT2 tumors, there was a detection rate of only 66.7%. Conclusions: This study underlines the fact that a considerable number of significant and potentially curable tumors remain undetected by the conventional sextant biopsy. A negative sextant biopsy does not rule out significant prostate cancer
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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33

Wirth, Manfred P., and Oliver W. Hakenberg. "Curative Treatment of Prostate Cancer." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133890.

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The guidelines for the curative treatment of prostate cancer presented by the German Society of Urology are discussed. They are based on the current knowledge of the outcomes of surgical and radiotherapeutic treatment for prostate cancer. Radical prostatectomy is recommended as the first-line treatment for organ-confined prostate cancer in patients with an individual life expectancy of at least 10 years. Radiotherapy can be considered as an alternative treatment modality, although current knowledge does not allow a definite assessment of the relative value of radiotherapy compared to radical prostatectomy. Locally advanced cT3 prostate cancer is overstaged in about 20% and curative treatment is possible in selected cases. Guidelines represent rules based on the available evidence. This implies that exceptions must be made whenever appropriate and that guidelines have to be reviewed regularly as new information becomes available
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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34

Fröhner, Michael, Rainer Litz, Andreas Manseck, Oliver W. Hakenberg, Steffen Leike, D. Michael Albrecht, and Manfred P. Wirth. "Relationship of Comorbidity, Age and Perioperative Complications in Patients Undergoing Radical Prostatectomy." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133867.

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Objectives: To investigate the prevalence and distribution of comorbidity and its association with perioperative complications in patients undergoing radical prostatectomy (RPE). Methods: In 431 unselected RPE patients, the American Society of Anesthesiologists Physical Status classification (ASA-PS), the New York Heart Association classification of cardiac insufficiency (NYHA), the classification of angina pectoris of the Canadian Cardiovascular Society (CCS), height, weight, the body mass index (BMI), and the number of concomitant diseases (NCD) were assessed and related to perioperative cardiovascular complications. Results: In RPE patients less than 70 years old, comorbidity rose nearly continuously with increasing age. However, after reaching an age of 70 years, the proportion of NYHA-0 patients increased (60–64 years, 86%; 65–69 years, 85%; ≥70 years, 87%). Furthermore, the severe comorbidities decreased in patients selected for RPE aged 70 or more years. There was a nonsignificant trend towards higher comorbidity in patients with perioperative cardiovascular complications. Conclusions: These data suggest that documentation of the distribution of ASA-PS, CCS, NYHA and of concomitant diseases might be helpful to characterize the general health status and the degree of selection of prostate cancer treatment populations especially in series with a high portion of patients aged 70 or more years. Concerning perioperative complications, the individual predictive value of comorbidity seems to be poor in the radical prostatectomy setting
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35

Hakenberg, Oliver W., Michael Fröhner, and Manfred P. Wirth. "Treatment of Locally Advanced Prostate Cancer – The Case for Radical Prostatectomy." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133798.

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The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment
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36

Fröhner, Michael, Oliver W. Hakenberg, Rainer Koch, Uta Schmidt, Axel Meye, and Manfred P. Wirth. "Comparison of the Clinical Value of Complexed PSA and Total PSA in the Discrimination between Benign Prostatic Hyperplasia and Prostate Cancer." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133807.

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Background: To compare the clinical value of the measurement of complex and total PSA in the discrimination between benign prostatic hyperplasia (BPH) and prostate cancer. Methods: In serum samples collected from 166 men with histopathologically proven clinically localized prostate cancer and of 97 men with BPH, total prostate-specific antigen (PSA), complexed PSA and the free to total PSA ratio were determined. The statistical analysis was done by the comparison of the receiver operator characteristic (ROC) curves. Results: The areas under the ROC curves were 0.776 for total PSA, 0.799 for complexed PSA (total PSA vs. cPSA: p < 0.0001) and 0.812 for the free to total PSA ratio. With a cut-off of 3.0 ng/ml for complexed PSA, the sensitivity was 90%, the specificity 58%, the positive and the negative predictive values 79 and 78%, respectively. With a cut-off of 4.0 ng/ml for total PSA, the sensitivity was 87%, the specificity 59%, the positive and the negative predictive values were 78 and 72%, respectively. Conclusions: There was a statistically significant advantage for complexed PSA compared to total PSA in the discrimination between BPH and prostate cancer. The difference was, however, small and its clinical relevance is questionable
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37

Wirth, Manfred. "Delaying/Reducing the Risk of Clinical Tumour Progression after Primary Curative Procedures." Karger, 2001. https://tud.qucosa.de/id/qucosa%3A27591.

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The advent of prostate-specific antigen (PSA) testing and increased patient awareness has led to patients being diagnosed with prostate cancer at an earlier stage and a younger age than previously. Adjuvant hormonal therapy to radiotherapy or prostatectomy has been shown to reduce the risk of tumour progression, and in some studies survival benefits have been demonstrated. The non-steroidal antiandrogen bicalutamide (‘Casodex’) has undergone extensive evaluation and is currently undergoing clinical trials as immediate therapy, either alone or as adjuvant to treatment of curative intent in patients with localized or locally advanced disease. Data from the first analysis of one of the studies in the Early Prostate Cancer (EPC) programme involving 3,603 patients have shown that, after a median follow-up of 2.6 years, the risk of prostate cancer progression was significantly reduced (by 43%) in patients receiving bicalutamide 150 mg compared with those receiving standard care alone (HR 0.57; 95% CI 0.48, 0.69; p ≪ 0.0001). The risk of PSA progression was also significantly reduced (by 63%). At this stage the survival data are still immature. Side effects of bicalutamide were mostly gynaecomastia and breast pain, which is consistent with its pharmacology. Overall withdrawal rates were similar in the bicalutamide 150 mg and standard care alone groups. In the bicalutamide 150 mg group, withdrawals were mainly due to side effects, whereas in the group receiving standard care alone, withdrawals were mainly due to disease progression. The programme is ongoing, and survival data are awaited.
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38

Anderson, John, Ghandi Al-Ali, Manfred Wirth, Joan Benejam Gual, Veiga Francisco Gomez, Enrico Colli, der Meulen Egbert van, and Bo-Eric Persson. "Degarelix versus Goserelin (+ Antiandrogen Flare Protection) in the Relief of Lower Urinary Tract Symptoms Secondary to Prostate Cancer: Results from a Phase IIIb Study (NCT00831233)." Karger, 2012. https://tud.qucosa.de/id/qucosa%3A71670.

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Introduction: No studies to date have assessed the efficacy/tolerability of degarelix in the relief of lower urinary tract symptoms (LUTS) secondary to prostate cancer (PrCa). Methods: Patients were randomised to degarelix 240/80 mg or goserelin 3.6 mg + bicalutamide flare protection (G+B); both treatments were administered for 3 months. The primary endpoint was change in International Prostate Symptom Score (IPSS) at week 12 compared with baseline. Results: This study was stopped early due to recruitment difficulties. 40 patients received treatment (degarelix n = 27; G+B n = 13); most had locally advanced disease and were highly symptomatic. Degarelix was non-inferior to G+B in reducing IPSS at week 12 in the full analysis set (p = 0.20); the significantly larger IPSS reduction in the per-protocol analysis (p = 0.04) was suggestive of superior reductions with degarelix. Significantly more degarelix patients had improved quality of life (IPSS question) at week 12 (85 vs. 46%; p = 0.01). Mean prostate size reductions at week 12 were 42 versus 25% for patients receiving degarelix versus G+B, respectively (p = 0.04; post hoc analysis). Most adverse events were mild/moderate; more degarelix patients experienced injection site reactions whereas more G+B patients had urinary tract infections/cystitis. Conclusion: In 40 men with predominantly locally advanced PrCa and highly symptomatic LUTS, degarelix was at least non-inferior to G+B in reducing IPSS at week 12.
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39

Schmidt, Siw. "Einfluss des Insulin-ähnlichen Wachstumsfaktors I auf die Androgenrezeptor-Signaltransduktion in Prostatakrebszellen." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2007. http://nbn-resolving.de/urn:nbn:de:swb:14-1195402741557-84879.

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Die im Rahmen dieser Arbeit durchgeführten Untersuchungen zum Einfluss der Wachstumsfaktoren IGF-I, EGF und dem Zytokin IL-6 auf den Androgenrezeptor-Signalweg zeigten in verschiedenen Prostatakarzinom-zelllinien schon nach zwei Stunden eine deutliche Degradation des Androgenrezeptor-Proteins. Die ausschließlich auf Protein-Ebene stattfindende, Wachstumsfaktor-induzierte negative Regulation des Androgenrezeptors konnte durch einen schnellen Androgeneffekt wieder aufgehoben werden. Mittels Luziferase-Reportergen-Assays wurde kein Einfluss der Wachstums-faktorwirkung auf die transkriptionelle Aktivität des Androgenrezeptors nachgewiesen. Darüber hinaus konnte eine signifikant reprimierende Wirkung durch IGF-I und EGF in Kombination mit geringen Mengen DHT beobachtet werden. Weitere Resultate dieser Arbeit deuten auf einen, durch den PI3-Kinase-Signalweg vermittelten, proteasomalen Abbauprozess des Rezeptors hin. Da die Suppression der downstream gelegenen Proteinkinase Akt keine Veränderung hinsichtlich der Degradation aufwies, konzentrierte sich die weiterführende Arbeit auf eine mögliche direkte Regulation des Androgen-rezeptors durch die PI3-Kinase. Unter Verwendung von rekombinanten GST-Fusionsproteinen konnte in Interaktionsstudien unter in vitro Bedingungen eine Phosphotyrosin-unabhängige Bindung zwischen der C-SH2-Domäne der p85-Untereinheit der PI3-Kinase und dem N- und C-Terminus des Androgenrezeptors nachgewiesen werden. Durch die nähere Charakterisierung dieser Bindungsbereiche mit Hilfe von Peptidarrays und anschließenden Alanin-Substitutionen war es möglich, für den N-Terminus 18, für den C-Terminus des Androgenrezeptors 6 und für die p85-C-SH2-Domäne der PI3-Kinase 11 Aminosäuren zu identifizieren. Die durch gezielte Punktmutagenese an diesen Aminosäurepositionen hergestellten Androgenrezeptor-Einzel- und -Mehrfachmutanten wiesen in Bindungsstudien dennoch Interaktion zur PI3-Kinase auf. Eine von Anderson und Kollegen postulierte Phosphotyrosin-unabhängige Bindung der SH2-Domänen der p85-Untereinheit der PI3-Kinase durch sogenannte „basic-X-basic“-Motive wurde ebenfalls in Interaktionstests zwischen der PI3-Kinase und dem Androgenrezeptor überprüft. Aufgrund der Tatsache, dass einige der identifizierten Aminosäuren auf dem Androgenrezeptor Teil eines „basic-X-basic“-Bindungsmotives sind, wurden Kombinationsmutanten generiert, die sowohl im N-Terminus als auch im C﷓Terminus des Androgenrezeptors ein bzw. zwei zerstörte „basic-X-basic“-Motive enthielten. Untersuchungen zum Bindungsverhalten dieser Mutanten zeigten zwar weiterhin Interaktion zur p85-C-SH2-Domäne der PI3-Kinase, jedoch der durch Western-blot-Analyse überprüfte IGF-I-induzierte Degradationseffekt des Androgenrezeptor-Proteins konnte mit zwei der verwendeten Androgenrezeptor-Kombinationsmutanten nicht mehr beobachtet werden.
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40

Wirth, Manfred P., and Michael Fröhner. "Adjuvant Hormonal Treatment for Prostate Cancer: The Bicalutamide Early Prostate Cancer Program." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133551.

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Adjuvant hormonal therapy has been demonstrated to be able to delay disease progression in nonmetastatic prostate cancer. To date, however, a favorable impact on survival has only been demonstrated in lymph-node-positive disease and in external-beam radiotherapy series with locally advanced and probably mainly micrometastatic tumors. The Bicalutamide Early Prostate Cancer Program is the largest study under way to define the role of adjuvant treatment in early prostate cancer and identify subgroups of patients likely to benefit from immediate hormonal therapy. At the time of the most recently published analysis, the risk of objective clinical progression was significantly reduced in the bicalutamide arm (hazards ratio 0.58, 95% confidence interval 0.51–0.66, p < 0.0001). However, further maturation of data is needed to see whether this difference will lead to a survival advantage
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41

Wirth, Manfred P., and Michael Fröhner. "Perspectives in Adjuvant Treatment of Prostate Cancer." Karger, 2002. https://tud.qucosa.de/id/qucosa%3A27540.

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42

Manseck, Andreas, Michael Fröhner, Sven Oehlschläger, Oliver W. Hakenberg, Katrin Friedrich, Franz Theissig, and Manfred P. Wirth. "Is Systematic Sextant Biopsy Suitable for the Detection of Clinically Significant Prostate Cancer?" Karger, 2000. https://tud.qucosa.de/id/qucosa%3A27545.

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Background: The optimal extent of the prostate biopsy remains controversial. There is a need to avoid detection of insignificant cancer but not to miss significant and curable tumors. In alternative treatments of prostate cancer, repeated sextant biopsies are used to estimate the response. The aim of this study was to investigate the reliability of a repeated systematic sextant biopsy as the standard biopsy technique in patients with significant tumors which are being considered for curative treatment. Methods: Systematic sextant biopsy was performed in vitro in 92 radical prostatectomy specimens. Of these patients, 81 (88.0%) had palpable lesions. Results: Of the 92 investigated patients, 70 (76.1%) had potentially curable pT2-3pN0 prostate cancers. In these patients, the cancer was detected only in 72.9% of cases by a repeated in vitro biopsy. In the pT2 tumors, there was a detection rate of only 66.7%. Conclusions: This study underlines the fact that a considerable number of significant and potentially curable tumors remain undetected by the conventional sextant biopsy. A negative sextant biopsy does not rule out significant prostate cancer.
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43

Wirth, Manfred P., and Oliver W. Hakenberg. "Curative Treatment of Prostate Cancer." Karger, 1999. https://tud.qucosa.de/id/qucosa%3A27546.

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The guidelines for the curative treatment of prostate cancer presented by the German Society of Urology are discussed. They are based on the current knowledge of the outcomes of surgical and radiotherapeutic treatment for prostate cancer. Radical prostatectomy is recommended as the first-line treatment for organ-confined prostate cancer in patients with an individual life expectancy of at least 10 years. Radiotherapy can be considered as an alternative treatment modality, although current knowledge does not allow a definite assessment of the relative value of radiotherapy compared to radical prostatectomy. Locally advanced cT3 prostate cancer is overstaged in about 20% and curative treatment is possible in selected cases. Guidelines represent rules based on the available evidence. This implies that exceptions must be made whenever appropriate and that guidelines have to be reviewed regularly as new information becomes available.
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44

Hakenberg, Oliver W., Michael Fröhner, and Manfred P. Wirth. "Treatment of Locally Advanced Prostate Cancer – The Case for Radical Prostatectomy." Karger, 2006. https://tud.qucosa.de/id/qucosa%3A27536.

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The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment.
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45

Fröhner, Michael, Oliver W. Hakenberg, Rainer Koch, Uta Schmidt, Axel Meye, and Manfred P. Wirth. "Comparison of the Clinical Value of Complexed PSA and Total PSA in the Discrimination between Benign Prostatic Hyperplasia and Prostate Cancer." Karger, 2006. https://tud.qucosa.de/id/qucosa%3A27537.

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Background: To compare the clinical value of the measurement of complex and total PSA in the discrimination between benign prostatic hyperplasia (BPH) and prostate cancer. Methods: In serum samples collected from 166 men with histopathologically proven clinically localized prostate cancer and of 97 men with BPH, total prostate-specific antigen (PSA), complexed PSA and the free to total PSA ratio were determined. The statistical analysis was done by the comparison of the receiver operator characteristic (ROC) curves. Results: The areas under the ROC curves were 0.776 for total PSA, 0.799 for complexed PSA (total PSA vs. cPSA: p < 0.0001) and 0.812 for the free to total PSA ratio. With a cut-off of 3.0 ng/ml for complexed PSA, the sensitivity was 90%, the specificity 58%, the positive and the negative predictive values 79 and 78%, respectively. With a cut-off of 4.0 ng/ml for total PSA, the sensitivity was 87%, the specificity 59%, the positive and the negative predictive values were 78 and 72%, respectively. Conclusions: There was a statistically significant advantage for complexed PSA compared to total PSA in the discrimination between BPH and prostate cancer. The difference was, however, small and its clinical relevance is questionable.
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46

Fröhner, Michael, Rainer Litz, Andreas Manseck, Oliver W. Hakenberg, Steffen Leike, D. Michael Albrecht, and Manfred P. Wirth. "Relationship of Comorbidity, Age and Perioperative Complications in Patients Undergoing Radical Prostatectomy." Karger, 2001. https://tud.qucosa.de/id/qucosa%3A27543.

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Objectives: To investigate the prevalence and distribution of comorbidity and its association with perioperative complications in patients undergoing radical prostatectomy (RPE). Methods: In 431 unselected RPE patients, the American Society of Anesthesiologists Physical Status classification (ASA-PS), the New York Heart Association classification of cardiac insufficiency (NYHA), the classification of angina pectoris of the Canadian Cardiovascular Society (CCS), height, weight, the body mass index (BMI), and the number of concomitant diseases (NCD) were assessed and related to perioperative cardiovascular complications. Results: In RPE patients less than 70 years old, comorbidity rose nearly continuously with increasing age. However, after reaching an age of 70 years, the proportion of NYHA-0 patients increased (60–64 years, 86%; 65–69 years, 85%; ≥70 years, 87%). Furthermore, the severe comorbidities decreased in patients selected for RPE aged 70 or more years. There was a nonsignificant trend towards higher comorbidity in patients with perioperative cardiovascular complications. Conclusions: These data suggest that documentation of the distribution of ASA-PS, CCS, NYHA and of concomitant diseases might be helpful to characterize the general health status and the degree of selection of prostate cancer treatment populations especially in series with a high portion of patients aged 70 or more years. Concerning perioperative complications, the individual predictive value of comorbidity seems to be poor in the radical prostatectomy setting.
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47

Manseck, Andreas, Karsten Guhr, Michael Fröhner, Oliver W. Hakenberg, and Manfred P. Wirth. "Morbidity and Discomfort of Ten-Core Biopsy of the Prostate Evaluated by Questionnaire." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133871.

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Transition zone biopsies have been found to increase the detection rates of cancer of the prostate in patients with negative digital rectal examination. There are however no data available whether the higher biopsy rate is associated with greater morbidity. The present study was therefore designed to evaluate the complication rate of extended sextant biopsy. In this prospective study, 162 consecutive patients who presented for prostatic evaluation were included. After starting prophylactic antibiotic treatment 48 h prior to the procedure, transrectal ultrasound-guided core biopsies were obtained from each lobe: three each from the peripheral zone (apex, mid-zone and base) and two from the transition zone of each prostatic lobe. In all patients a questionnaire was obtained 10–12 days after the procedure. Major complications occurred in 3 patients. In 2 of the 3 cases major macroscopic hematuria was treated by an indwelling catheter for 1 or 2 days and 1 patient developed fever >38.5°C for 1 day. Minor macroscopic hematuria was present in 68.5% of the patients. In 17.9% of these cases, the hematuria lasted for more than 3 days. Hematospermia was observed in 19.8% and minor rectal bleeding occurred in 4.9%. Ten-core biopsies did not lead to an increase in adverse effects or complications when compared to the results of sextant biopsies reported in the literature
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48

Pirozhok, Igor, Axel Meye, Oliver W. Hakenberg, Susanne Füssel, and Manfred P. Wirth. "Serotonin and Melatonin Do Not Play a Prominent Role in the Growth of Prostate Cancer Cell Lines." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133758.

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Objectives: To investigate the effects of serotonin and melatonin (MLT) on the regulation of malignant growth and the activity of serotonin receptors (5HTR1a/-1b) in prostate cancer (PCa) cell lines. Materials and Methods: In four PCa cell lines (LNCaP, 22RV1, PC3, DU145) and two reference cell lines 5HTR1a and -1b, relative mRNA expression levels were assessed. Different serotonin and MLT receptor agonists and antagonists were used in stimulation and inhibition experiments. Results: mRNA expression of 5HTR1b was higher than that of 5HTR1a in all PCa cell lines. Serotonin showed a significant growth stimulatory effect in all PCa lines. The 5HTR1a and -1b agonists/antagonists did not significantly affect viability. MLT inhibited viability only in PC3 cells. Similarly, the 5HTR1a antagonist induced apoptotic changes in PC3 cells only at 10–4M, while the 5HTR1b antagonist induced necrosis at 10–4M in all cell lines. Cell cycle alterations were seen in PC3 and DU145 cells under the influence of the 5HTR1a antagonist. Conclusions: Serotonin receptor antagonists and agonists as well as MLT influence viability and apoptosis of PCa cell lines at supraphysiologic concentrations. In contrast to other reports, our results do not support a regulatory role of serotonin or MLT receptor activation or inhibition in PCa growth
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49

Wirth, Manfred P., and Michael Fröhner. "Adjuvant Hormonal Treatment for Prostate Cancer: The Bicalutamide Early Prostate Cancer Program." Karger, 2003. https://tud.qucosa.de/id/qucosa%3A27515.

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Abstract:
Adjuvant hormonal therapy has been demonstrated to be able to delay disease progression in nonmetastatic prostate cancer. To date, however, a favorable impact on survival has only been demonstrated in lymph-node-positive disease and in external-beam radiotherapy series with locally advanced and probably mainly micrometastatic tumors. The Bicalutamide Early Prostate Cancer Program is the largest study under way to define the role of adjuvant treatment in early prostate cancer and identify subgroups of patients likely to benefit from immediate hormonal therapy. At the time of the most recently published analysis, the risk of objective clinical progression was significantly reduced in the bicalutamide arm (hazards ratio 0.58, 95% confidence interval 0.51–0.66, p < 0.0001). However, further maturation of data is needed to see whether this difference will lead to a survival advantage.
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50

Hammerer, Peter G., and Manfred P. Wirth. "Health-Related Quality of Life in 536 Long-Term Prostate Cancer Survivors after Treatment with Leuprorelin Acetate: A Combined Retrospective and Prospective Analysis." Karger, 2018. https://tud.qucosa.de/id/qucosa%3A70627.

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Introduction: We investigated the health-related quality of life (HRQoL) of long-term prostate cancer patients who received leuprorelin acetate in microcapsules (LAM) for androgen-deprivation therapy (ADT). Methods: The observational study was carried out by 30 office-based German urologists in 536 prostate cancer (PCa) patients treated for ≥5 years with LAM and in 116 patients of an age-matched control group (CG). Data on HRQoL and health status was collected prospectively using validated questionnaires QLQ-C30, QLQ-PR25 and Karnofsky Index. Data on effectiveness (clinical response, prostate specific antigen [PSA], testosterone) and safety was collected retrospectively from patients’ health records. We used descriptive statistics to analyze the data. Results: The mean treatment duration was 8.6 years (range 4.5–19.8 years). General health status (QLQ-C30) was comparable for both groups. Differences were observed regarding physical – and role functioning. ADT patients rated single items slightly worse than CG. Karnofsky-Index showed comparable high values (median of 90%). QLQ-PR25 revealed more PCa-related symptoms for ADT patients. Within 6 months, median PSA level declined >90% and median testosterone levels declined below castration level from 4.0 to 0.2 ng/mL. Clinical response (European Organisation for Research and Treatment of Cancer criteria) was observed in at least 90% of ADT patients. Conclusions: Long-term ADT with LAM is a well-accepted, tolerated, effective, and low-burden treatment option for patients with advanced, hormone-sensitive PCa.
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