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Prostatakarzinom

Prostatic carcinoma

  • CME Weiterbildung • Zertifizierte Fortbildung
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Der Onkologe Aims and scope

Zusammenfassung

Das Prostatakarzinom ist das häufigste Karzinom des Mannes. Die Anzahl früh entdeckter Tumoren stieg durch intensivierte Vorsorgeuntersuchungen, deren Effektivität ist jedoch unzureichend. Die bildgebenden Verfahren bieten heute eine verbesserte Treffsicherheit, beantworten aber nicht alle Fragen. Der Einsatz von Biomarkern könnte künftig die Diagnostik optimieren. Eine kurative Behandlung durch Operation und Bestrahlung ist bei lokal begrenzten Karzinomen möglich. Die Qualität der Operation hängt v. a. von der Erfahrung des Operateurs, die Wirkung der Bestrahlung von der Präzision und der Dosis ab. Ein Fortschreiten der Erkrankung nach Primärtherapie macht sich früh durch einen PSA(prostataspezifisches Antigen)-Anstieg bemerkbar. Lokale Rezidive können anhängig von der Primärtherapie radiotherapeutisch, chirurgisch oder medikamentös angegangen werden. Bei generalisierter Erkrankung kommen bestimmte chemotherapeutische Verfahren in Frage. Das klinische Management wird nach wie vor kontrovers diskutiert.

Abstract

Prostatic carcinoma is the most common cancer in men. Intensified screening has increased the number of prostate carcinomas detected early; however, screening effectiveness is still insufficient. Although modern diagnostic imaging procedures offer improved accuracy, they are not able to answer all questions. The use of biomarkers in the future could optimize diagnosis further. Surgery and radiotherapy offer a chance of cure in local carcinoma. The quality of prostatectomy depends primarily on the expertise and experience of the surgeon, while the efficacy of radiotherapy depends on precision and radiation dose. Disease progression following primary therapy is detected early by increased PSA (prostate-specific antigen). Depending on primary therapy, local recurrence can be successfully treated using radiotherapy, surgery or drug therapy. In the case of generalized disease, certain chemotherapeutic procedures can be considered. Clinical management of prostate carcinoma, however, remains controversial.

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Authors and Affiliations

  1. Klinik für Strahlentherapie und Radio-Onkologie, Marienhospital Herne, Klinikum der Ruhr-Universität Bochum, Herne, Hölkeskampring 40, 44625, Herne, Deutschland

    I.A. Adamietz

  2. Klinik für Urologie, Klinikum Kassel GmbH, Kassel, Deutschland

    K. Czeloth

  3. Universitätsklinik für Radioonkologie, Tübingen, Deutschland

    U. Ganswindt

  4. Urologische Klinik, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland

    K. Miller

  5. Department of Pathology, Brigham & Women’s Hospital/Harvard Medical School, Boston, MA, USA

    S. Perner

  6. Klinik für Nuklearmedizin, Universität Ulm, Ulm, Deutschland

    S.N. Reske

  7. Klinik für Urologie, Universitätsklinik Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland

    J. Walz

  8. II. Medizinische Klinik, Onkologisches Zentrum, Universitätsklinik Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland

    J. Wierecky

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  1. I.A. Adamietz
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  2. K. Czeloth
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  3. U. Ganswindt
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  4. K. Miller
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  5. S. Perner
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  6. S.N. Reske
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  7. J. Walz
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  8. J. Wierecky
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Correspondence to I.A. Adamietz.

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Adamietz, I., Czeloth, K., Ganswindt, U. et al. Prostatakarzinom. Onkologe 14, 1087–1102 (2008). https://doi.org/10.1007/s00761-008-1492-0

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