Kälble T, Fichtner J
Klinik für Urologie und Kinderurologie, Klinikum Fulda gAG, Pacelliallee 4, 3643, Fulda, Deutschland.
Urologische Klinik, Evangelisches Klinikum Niederrhein, Oberhausen, Deutschland.
Urologe A. 2015 Nov;54(11):1523-4, 1526-9. doi: 10.1007/s00120-015-3994-x.
As of 31 December 2012, 92 departments of urology had been certified as a prostate cancer center by the German Cancer Society (DKG). In this paper, the treatment quality of these centers based on the annual 2014 DKG report shall be critically analyzed.
In 2013, 19,558 primary cases of prostate cancer were registered. The mean number of primary cases per year was 159 (range 101-2089), whereby the minimum number of > 100 had been reached by all centers. The median number of radical prostatectomies decreased to 84 (range 35-2145); 6 of 88 centers did not fulfill the minimum number of 50 radical prostatectomies per year. Concerning radiotherapy or brachytherapy no minimal requirements exist.
The number of operative revisions and wound infections including drainage of lymphoceles following radical prostatectomies and the relative number of nerve-sparing radical prostatectomies in low-risk patients with an IIEF > 22 are described. The requirement of < 10 % R1 resections was only fulfilled in 52 of 86 (60.5 %) centers; the median was 8.9 %. Data concerning treatment quality of external beam irradiation as well as data for potency and continence of all treatment modalities are completely lacking.
The large number of registered prostate cancer cases offers the perfect opportunity to generate reliable benchmark data for all treatment modalities of prostate cancer. It is desirable that in the near future functional data such as continence and potency rates as well as prostate-specific antigen (PSA) recurrences of all treatment modalities will be reported.
截至2012年12月31日,92个泌尿外科科室已被德国癌症协会(DKG)认证为前列腺癌中心。本文将根据2014年DKG年度报告对这些中心的治疗质量进行批判性分析。
2013年,共登记了19558例原发性前列腺癌病例。每年原发性病例的平均数量为159例(范围为101 - 2089例),所有中心均达到了>100例的最低数量。根治性前列腺切除术的中位数降至84例(范围为35 - 2145例);88个中心中有6个未达到每年50例根治性前列腺切除术的最低数量。关于放射治疗或近距离放射治疗,不存在最低要求。
描述了根治性前列腺切除术后手术修正和伤口感染(包括淋巴囊肿引流)的数量,以及国际勃起功能指数(IIEF)>22的低风险患者中保留神经的根治性前列腺切除术的相对数量。仅86个中心中的52个(60.5%)满足<10%的R1切除要求;中位数为8.9%。完全缺乏关于外照射治疗质量的数据以及所有治疗方式的性功能和控尿功能的数据。
大量登记的前列腺癌病例为生成前列腺癌所有治疗方式的可靠基准数据提供了绝佳机会。希望在不久的将来能报告所有治疗方式的控尿率、性功能率以及前列腺特异性抗原(PSA)复发等功能数据。