Stöckle Michael, Bussar-Maatz Roswitha
Klinik für Urologie und Kinderurologie der Universität des Saarlandes, Homburg an der Saar.
Z Evid Fortbild Qual Gesundhwes. 2012;106(5):333-5; discussion 335. doi: 10.1016/j.zefq.2012.05.004. Epub 2012 Jun 18.
Prostate cancer is the most common carcinoma of the elderly man and holds the third place in the ranking of cancer-specific mortality. However, mortality rates of 3 % are low, and half of the patients will die from intercurrent disease. Due to the significantly improved diagnostic methods and the increasing use of PSA screening, there has been a stage migration towards early tumour stages that are prognostically heterogeneous and require differentiated treatment. Based on the discussions of the Joint Federal Committee (G-BA) and the conceptual work of the MDS, the Competence Centre Oncology of the MDK, the IQWIG and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), a prospective randomised multicentre trial was developed comparing the four treatments actually recommended by the German and European guidelines for localised prostate cancer (radical prostatectomy, percutaneous radiotherapy and permanent seed implantation and active surveillance) allowing a rejection of one or two treatment options. The trial is expected to start at the beginning of next year.
前列腺癌是老年男性最常见的癌症，在癌症特异性死亡率排名中位居第三。然而，3%的死亡率较低，半数患者将死于并发疾病。由于诊断方法显著改进以及前列腺特异性抗原（PSA）筛查的使用增加，肿瘤分期已向早期转移，这些早期肿瘤阶段在预后方面具有异质性，需要进行差异化治疗。基于联邦联合委员会（G-BA）的讨论以及德国医疗质量与效率研究所（IQWIG）、MDK肿瘤学能力中心、MDS的概念性工作以及法定医疗保险基金全国协会（GKV-Spitzenverband）的讨论，开展了一项前瞻性随机多中心试验，比较德国和欧洲指南实际推荐的四种针对局限性前列腺癌的治疗方法（根治性前列腺切除术、经皮放疗、永久性粒子植入和主动监测），以便排除一种或两种治疗方案。该试验预计将于明年年初启动。
