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01.06.2017 | original article | Ausgabe 11-12/2017

Wiener klinische Wochenschrift 11-12/2017

Active surveillance for low-risk prostate cancer in Austria: the online registry of the Qualitätspartnerschaft Urologie (QuapU)

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 11-12/2017
Autoren:
Klaus Eredics, Karl Dorfinger, Gero Kramer, Anton Ponholzer, Stephan Madersbacher
Wichtige Hinweise
Klaus Eredics, Karl Dorfinger, Gero Kramer, Anton Ponholzer, and Stephan Madersbacher represent the Qualitätspartnerschaft Urologie.

Summary

Background

Active surveillance (AS) is a well-recognized strategy to reduce the risk of overtreatment in men with low-risk prostate cancer. No data on this approach are available from Austria.

Methods

The Qualitätspartnerschaft Urologie (QuapU) developed an online database for patients managed with AS in Austria. Principal inclusion/exclusion criteria corresponded to those of the S3 prostate cancer guideline of German urologists: prostate-specific antigen (PSA) <10 ng/ml, Gleason score <7 (maximum 20% of biopsies being positive). Control visits were scheduled at 3‑month intervals, control biopsies were scheduled at 12 and 36 months.

Results

To date 131 patients have been entered into this data base. Mean patient age is 64 years, 6% were younger than 50 years, two thirds of patients were aged 50–70 years and 25% were older than 70 years. Mean PSA value was 5.9 ng/ml (PSA 0–4 ng/ml: 15%; PSA >4–10 ng/ml: 85%). The prostate volume averaged 39 ml. The mean time under AS was 17.5 months (<12 months: 60%; >12 months: 40%). The AS adherence at 12 months was 85% and at 24 months 76%. To date, a total of 23 patients (17.6%) stopped AS. The most frequent reasons for discontinuing AS were patient wish for active treatment (43.5%) and PSA progression (30.4%). A histological progression was rarely seen (6.1%) and the control biopsy rate was low (19.8%).

Conclusion

This study is the first description of AS in Austria and documents the feasibility of an online registry for AS. The data confirm the international experience with this approach with acceptable adherence rates.

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