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Hochrisikopatienten mit neu diagnostiziertem Prostatakarzinom

Stellenwert adjuvanter und neoadjuvanter Therapiekonzepte

Patients with a new diagnosis of high-risk prostate carcinoma

Relative importance of adjuvant and neoadjuvant therapy

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Zusammenfassung

Patienten mit neu diagnostiziertem frühem Prostatakarzinom und erhöhtem Rezidivrisiko werden durch eine rein lokale Behandlung in der Regel nicht geheilt. Wie die Therapiestrategie für einen optimalen Therapieerfolg — möglichst Heilung — aussehen sollte, ist Gegenstand der klinischen Prüfung. Klinische Studien weisen auf einen Überlebenszeitgewinn durch multimodale Therapiekonzepte hin. Im Fokus stehen die adjuvante Strahlentherapie nach radikaler Prostatektomie (RP) sowie der frühzeitige — adjuvante und/oder neoadjuvante — Einsatz von Hormon- und Chemotherapie. Unabhängig davon ist zu definieren, bei welchen Patienten ein erhöhtes Rezidivrisiko vorliegt.

Abstract

Patients with a new diagnosis of early prostate cancer with a high risk of recurrence often cannot be cured with definitive local therapy alone. Therefore the optimal treatment strategy for these patients is still unknown. The role and timing of adjuvant therapy after definitive local therapy remain controversial. However in clinical trials patients with high-risk disease benefit form adjuvant treatment, either radiotherapy or adjuvant androgen deprivation therapy. Prospective randomized trials are underway to test the hypothesis that neoadjuvant and adjuvant chemotherapy may improve survival in these patients. However, it remains to be defined which patients with newly diagnosed high-risk prostate cancer have a high risk of recurrence.

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Authors and Affiliations

  1. Urologische Klinik, Caritas-Krankenhaus Bad Mergentheim

    J. M. Wolff

  2. Urologische Klinik, Caritas-Krankenhaus Bad Mergentheim, Uhlandstraße 7, 97 980, Bad Mergentheim

    J. M. Wolff

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Correspondence to J. M. Wolff.

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Wolff, J.M. Hochrisikopatienten mit neu diagnostiziertem Prostatakarzinom. Onkologe 11, 1115–1119 (2005). https://doi.org/10.1007/s00761-005-0954-x

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  • DOI: https://doi.org/10.1007/s00761-005-0954-x

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