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So wurden teilweise Angaben in ml, in cm sowie in Prozentwerten angegeben, so dass eine Verarbeitung uns als nicht sinnvoll erschien.
Die Angaben sind dabei in vier Kategorien unterteilt. Fall 1 3. Bei einem hypothetischen Fall wurden die oben genannten Angaben zu Patient und histopathologischem Befund gemacht.
Zudem wurden teilweise Mehrfachangaben gemacht. Die Auswertung ist nachfolgend in Abbildung 16 dargestellt.
Die grafische Darstellung findet sich in Abbildung Ergebnisse - 36 - 3. Ergebnisse - 37 - 3. Ergebnisse - 38 - Fall 3 3. Insgesamt sind die Angaben von 89 Urologen mit in die Statistik eingeflossen.
Ergebnisse - 39 - 3. Dabei wurden Angaben von 89 Urologen in die Statistik mit einbezogen. Ergebnisse - 40 - Fall 4 3.
Ergebnisse - 41 - 3. Hierzu machten 82 Urologen teilweise Mehrfachangaben. Angaben von 82 Urologen. Zeitmangel vermutet werden.
Diskussion - 43 - 4. So geben auf die Frage nach der Berufserfahrung bzw. Als Konsequenz der Ergebnisse eines umfangreich angelegten systematischen Reviews von Eichler et al.
Dabei muss auch die Zone der Prostata angegeben werden laterale periphere, mittlere periphere, transitionale Zone , aus der die Probe entnommen wurde.
TRUS entnommen werden, wobei diese individuell anzupassen sind. Dies sollte eigentlich bedeuten, dass der Biopsie der Transitionalzone eine eher geringere Bedeutung zukommt.
Die aktuellen Leitlinien nehmen hierzu allerdings keine klare Stellung. Da die Publikation von Pelzer et al.
Djavan et al. Yates et al. Dieses Vorgehen schien den Befragten nicht bekannt zu sein. Abrahamsson ; Andriole ]. Kaplan et al. Castellucci et al.
Choi et al. Bisherige Entwicklungen sind aber vielversprechend. Fallbeispiele 4. Angegeben war jedoch nur der Gesamtscore. Therapientscheidung auszurichten.
Sie kamen daher zu der Empfehlung diesem selektionierten Patientengut mit perineuraler Invasion eine aggressivere Therapie z. Masieri et al.
Aufgrund der aktuellen Datenlage [Gutierrez et al. Diskussion - 56 - ; Masieri et al. Jeon et al. Der entsprechende Fehler ist im Fragebogen im Anhang allerdings korrigiert.
Angaben zu der Fragestellung machten insgesamt 89 Urologen. Insgesamt 49 Mal wurde eine Rebiopsie, wie von der aktuellen Literatur und den S3-Leitlinien empfohlen, genannt.
Hintergrund dieser Frage war es, einen Eindruck zu bekommen, welche weiteren Parameter aus histopathologischen Befundberichten von den befragten Urologen als wichtig erachtet werden.
Wichtig scheint hier die Information zu sein, ob es sich schon um ein cT3 bzw. Gerade bei cT3 bzw. Ebenso wird eine Skelettszintigrafie empfohlen.
In einer vergleichbaren Studie, die von Descazeaud et al. Durch diese Studie konnte gezeigt werden wie wichtig es ist, die aus hochevidenten Studien gewonnene therapeutische Konsequenzen gezielt in Leitlinien zusammenzufassen und daraus Empfehlungen klar zu definieren anhand dieser sich die betroffene Berufsgruppe orientieren kann.
Zusammenfassung - 60 - 5. Dies macht deutlich wie entscheidend eine zielgerichtete Diagnostik und die sich daraus ableitende Therapie ist.
Die Studie hat gezeigt, dass es hinsichtlich dem Vorgehen, z. B bei der Anzahl der entnommenen Stanzzylinder, deutliche Abweichungen zwischen den Urologen gibt und die durch Leitlinien empfohlenen Standards nicht immer konsequent umgesetzt werden.
Ebenso konnte anhand der Fallbeispiele gezeigt werden, wie einige Urologen ihre Therapieentscheidung anhand nicht ausreichender histopathologischer Befunde ausrichten.
Durch diese Studie konnte damit deutlich gezeigt werden, wie wichtig klare Empfehlungen durch Leitlinien sind, und wie deutlich die befragte Gruppe teilweise von diesen abweicht.
Literaturverzeichnis - 61 - 6. Literatur 1. Baseline staging of newly diagnosed prostate cancer: a summary of the literature.
J Urol 2. J Am Med Assoc 3. Chemoprevention of prostate cancer in men at high risk: rationale and design of the reduction by dutasterid of prostate cancer events REDUCE trial.
J Urol 5. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 6. A study on staging bone scans in newly diagnosed prostate cancer.
Urol Int Literaturverzeichnis 7. Overdiagnosis and overtreatment of early detected prostate cancer. World J Urol 8.
Barry MJ. Early detection and aggressive treatment of prostate cancer; groping in the dark. J Gen Intern Med 9. Perineural invasion is associated with increased relapse after external beam radiotherapy for men with low-risk prostate cancer and may be a marker for occult, high-grade cancer.
Berufsverband Deutscher Pathologen e. Version 1. Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol Repeat biopsy in patients with atypical small acinar proliferation or high grade prostatic intraepithelial neoplasia on initial prostate needle biopsy.
J Urol Architectural patterns of high-grade prostatic intraepithelial neoplasia. Hum Pathol Bostwick DG, Quian J.
High-grade prostatic intaepithelial neoplasia. Mod Pathol Literaturverzeichnis Mendelian inheritance of familial prostate cancer.
Temporarily deferred therapy watchful waiting for men younger than 70 years and low-risk localized prostate cancer in the prostatic-specific antigen era.
J Clin Oncol Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease.
J Am Med Assoc Overuse of imaging for staging low risk prostate cancer. The effectiviness of screening for prostate cancer: a nested case-control study.
Arch Intern Med Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer.
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