Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener klinische Wochenschrift 11-12/2017

01.06.2017 | original article

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

verfasst von: Klaus Eredics, Karl Dorfinger, Gero Kramer, Anton Ponholzer, Stephan Madersbacher

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 11-12/2017

Einloggen, um Zugang zu erhalten
share
TEILEN

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.
Literatur
2.
Zurück zum Zitat Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320–8. CrossRefPubMed Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320–8. CrossRefPubMed
3.
Zurück zum Zitat Hugosson J, Carlsson S, Aus G, Bergdahl S, Khatami A, Lodding P, et al. Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncol. 2010;11:725–32. CrossRefPubMedPubMedCentral Hugosson J, Carlsson S, Aus G, Bergdahl S, Khatami A, Lodding P, et al. Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncol. 2010;11:725–32. CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent – update 2013. Eur Urol. 2014;65(1):124–37. CrossRefPubMed Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent – update 2013. Eur Urol. 2014;65(1):124–37. CrossRefPubMed
5.
Zurück zum Zitat AUA Prostate Cancer Clinical Guideline Update Pane, Thompson I, Thrasher JB, Aus G, Burnett AL, Canby-Hagino ED, Cookson MS, et al. Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol. 2007;177(6):2106–31. CrossRef AUA Prostate Cancer Clinical Guideline Update Pane, Thompson I, Thrasher JB, Aus G, Burnett AL, Canby-Hagino ED, Cookson MS, et al. Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol. 2007;177(6):2106–31. CrossRef
7.
Zurück zum Zitat Loeb S, Berglund A, Stattin P. Population based study of use and determinants of active surveillance and watchful waiting for low and intermediate risk prostate cancer. J Urol. 2013;190:1742–9. CrossRefPubMed Loeb S, Berglund A, Stattin P. Population based study of use and determinants of active surveillance and watchful waiting for low and intermediate risk prostate cancer. J Urol. 2013;190:1742–9. CrossRefPubMed
8.
Zurück zum Zitat Bokhorst LP, Bokhorst LP, Valdagni R, Rannikko A, Kakehi Y, Pickles T, Bangma CH, Roobol MJ, PRIAS study group. A decade of active surveillance in the PRIAS study: an update and evaluation of the criteria used to recommend a switch to active treatment. Eur Urol. 2016;70(6):954–60. doi: 10.​1016/​j.​eururo.​2016.​06.​007. CrossRefPubMed Bokhorst LP, Bokhorst LP, Valdagni R, Rannikko A, Kakehi Y, Pickles T, Bangma CH, Roobol MJ, PRIAS study group. A decade of active surveillance in the PRIAS study: an update and evaluation of the criteria used to recommend a switch to active treatment. Eur Urol. 2016;70(6):954–60. doi: 10.​1016/​j.​eururo.​2016.​06.​007. CrossRefPubMed
9.
Zurück zum Zitat Klotz L, Vesprini D, Sethukavalan P, Jethava V, Zhang L, Jain S, Yamamoto T, Mamedov A, Loblaw A. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol. 2015;33:272–7. CrossRefPubMed Klotz L, Vesprini D, Sethukavalan P, Jethava V, Zhang L, Jain S, Yamamoto T, Mamedov A, Loblaw A. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol. 2015;33:272–7. CrossRefPubMed
10.
Zurück zum Zitat Tosoian JT, Trock BJ, Landis P, Feng Z, Epstein JI, Partin AW, Walsh PC, Carter HB. Active surveillance program for prostate cancer: an update of the John Hopkins experience. J Clin Oncol. 2011;29:2185–90. CrossRefPubMed Tosoian JT, Trock BJ, Landis P, Feng Z, Epstein JI, Partin AW, Walsh PC, Carter HB. Active surveillance program for prostate cancer: an update of the John Hopkins experience. J Clin Oncol. 2011;29:2185–90. CrossRefPubMed
11.
Zurück zum Zitat Soloway MS, Soloway CT, Eldefrawy A, Acosta K, Kava B, Manoharan M. Careful selection and close monitoring on active surveillance minimizes the need for treatment. Eur Urol. 2010;58:831–5. CrossRefPubMed Soloway MS, Soloway CT, Eldefrawy A, Acosta K, Kava B, Manoharan M. Careful selection and close monitoring on active surveillance minimizes the need for treatment. Eur Urol. 2010;58:831–5. CrossRefPubMed
12.
Zurück zum Zitat Van den Bergh RCN, Roemeling S, Robol MJ, Aus G, Hugosson J, Rannikkko AS, Tammela TL, Bangma CH, Schröder FH. Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly. Eur Urol. 2009;55:1–8. CrossRefPubMed Van den Bergh RCN, Roemeling S, Robol MJ, Aus G, Hugosson J, Rannikkko AS, Tammela TL, Bangma CH, Schröder FH. Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly. Eur Urol. 2009;55:1–8. CrossRefPubMed
13.
Zurück zum Zitat Dall’Era MA, Konety BR, Cowan JE, Shinohara K, Stauf F, Cooperberg MR, et al. Active surveillance for the management of prostate cancer in a contemporary cohort. Cancer. 2008;112:2664–70. CrossRefPubMed Dall’Era MA, Konety BR, Cowan JE, Shinohara K, Stauf F, Cooperberg MR, et al. Active surveillance for the management of prostate cancer in a contemporary cohort. Cancer. 2008;112:2664–70. CrossRefPubMed
14.
Zurück zum Zitat Cristea O, Lavallee LT, Montroy J, Stokl A, Cnossen S, Mallick R, et al. Active surveillance in Canadian men with low-grade prostate cancer. CMAJ. 2016;188:E141–E147. CrossRefPubMedPubMedCentral Cristea O, Lavallee LT, Montroy J, Stokl A, Cnossen S, Mallick R, et al. Active surveillance in Canadian men with low-grade prostate cancer. CMAJ. 2016;188:E141–E147. CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Glass AS, Cooperberg MR, Meng MV, Carroll PR. Role of active surveillance in the management of localized prostate cancer. J Natl Cancer Inst Monographs. 2012;45:202–6. CrossRef Glass AS, Cooperberg MR, Meng MV, Carroll PR. Role of active surveillance in the management of localized prostate cancer. J Natl Cancer Inst Monographs. 2012;45:202–6. CrossRef
16.
Zurück zum Zitat Lelly SP, Van Den Eeden SK, Hoffman RM, Aaronson DS, Lobo T, Luta G, et al. Sociodemographic and clinical predictors of switching to active treatment among a large, ethnically diverse cohort of men with low risk prostate cancer on observational management. J Urol. 2016;196(3):734–40. doi: 10.​1016/​j.​juro.​2016.​04.​045. CrossRef Lelly SP, Van Den Eeden SK, Hoffman RM, Aaronson DS, Lobo T, Luta G, et al. Sociodemographic and clinical predictors of switching to active treatment among a large, ethnically diverse cohort of men with low risk prostate cancer on observational management. J Urol. 2016;196(3):734–40. doi: 10.​1016/​j.​juro.​2016.​04.​045. CrossRef
17.
Zurück zum Zitat Moore CM, Giganti F, Albertsen P, Allen C, Bangma C, Briganti A, et al. Reporting magnetic resonance imaging in men on active surveillance for prostate cancer: the PRECISE recommendations – a report of a European School of Oncology task force. Eur Urol. 2016; doi: 10.​1016/​j.​eururo.​2016.​06.​011. Moore CM, Giganti F, Albertsen P, Allen C, Bangma C, Briganti A, et al. Reporting magnetic resonance imaging in men on active surveillance for prostate cancer: the PRECISE recommendations – a report of a European School of Oncology task force. Eur Urol. 2016; doi: 10.​1016/​j.​eururo.​2016.​06.​011.
18.
Zurück zum Zitat Kim TH, Jeong JY, Lee SW, Kim CK, Park BK, Sung HH, et al. Diffusion-weigthed magnetic resonance imaging for prediction of insignificant prostate cancer in potential candidates for active surveillance. Eur Radiol. 2015;25:1786–92. CrossRefPubMed Kim TH, Jeong JY, Lee SW, Kim CK, Park BK, Sung HH, et al. Diffusion-weigthed magnetic resonance imaging for prediction of insignificant prostate cancer in potential candidates for active surveillance. Eur Radiol. 2015;25:1786–92. CrossRefPubMed
19.
Zurück zum Zitat Mullins JK, Bonekamp D, Landis P, Begun H, Partin AW, Epstein JL, et al. Multiparametric magnetic resonance imaging findings in men with low-risk prostate cancer followed using active surveillance. BJU Int. 2013;111:1037–45. CrossRefPubMedPubMedCentral Mullins JK, Bonekamp D, Landis P, Begun H, Partin AW, Epstein JL, et al. Multiparametric magnetic resonance imaging findings in men with low-risk prostate cancer followed using active surveillance. BJU Int. 2013;111:1037–45. CrossRefPubMedPubMedCentral
Metadaten
Titel
Active surveillance for low-risk prostate cancer in Austria: the online registry of the Qualitätspartnerschaft Urologie (QuapU)
verfasst von
Klaus Eredics
Karl Dorfinger
Gero Kramer
Anton Ponholzer
Stephan Madersbacher
Publikationsdatum
01.06.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 11-12/2017
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-016-1149-8

Weitere Artikel der Ausgabe 11-12/2017

Wiener klinische Wochenschrift 11-12/2017 Zur Ausgabe

mitteilungen der gesellschaft der ärzte in wien

Veranstaltungen