Prognosefaktoren des Prostatakarzinoms

C. G. Fischer; J. E. Altwein; H. J. Luboldt

doi:10.1055/s-2001-10742

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Aktuelle Urol 2001; 32(1): 3-10
DOI: 10.1055/s-2001-10742

ÜBERSICHT

Georg Thieme Verlag Stuttgart · New York

Prognosefaktoren des Prostatakarzinoms

Prognostic Factors in Prostate CancerC. G. Fischer¹ , J. E. Altwein² , H. J. Luboldt³

¹Urologische Universitätsklinik Gießen
²Urologische Abteilung, Krankenhaus der Barmherzigen Brüder München
³Urologische Universitätsklinik Essen

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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung

Prognostische Faktoren für das Prostatakarzinom müssen signifikant, unabhängig und wichtig sein. Signifikant bedeutet in diesem Zusammenhang, dass der Faktor nicht nur zufällig auftritt. Unabhängig bedeutet, dass er seinen Vorhersagewert behält, wenn neue Faktoren hinzukommen. Wichtig bedeutet, dass er direkt Therapieentscheidungen beeinflusst. Zu unterscheiden sind patienten-, tumor- und therapiebezogene prognostische Faktoren. Die Etablierung neuer Prognosefaktoren außerhalb dieser Systematik und ohne Berücksichtigung der methodischen Anforderungen an ihre Bewertung führt zu einer Inflation neuer Parameter ohne Bedeutung, da ein Patient immer nur einer prognostischen Gruppe zugeteilt werden kann. Gesicherte prognostische Faktoren des Prostatakarzinoms sind Metastasierung, Lymphknotenbefall, Grading, positive Schnittränder, extrakapsuläres Wachstum und Samenblasenbefall. Trotz der Flut neuer Biomarker hat bisher nur das PSA seinen prognostischen Wert zur Abschätzung des progressionsfreien Überlebens behalten.

Abstract

Prognostic factors in prostate cancer must be significant, independent and clinically important. “Significant” means the factor rarely occurs by chance, “independent” means the factor retains its value even when new factors are added and “clinically important” means the factor influences therapy. They should furthermore be classified into patient-related, tumor-related and treatment-related factors. If new prognostic factors are established without adherence to these guidelines, there results an exponential increase of meaningless parameters, as an individual patient can only belong to one prognostic group. Prognostic factors with established values are metastases, lymph node involvement, grade, positive margins, extracapsular extension and seminal vesical invasion. Among the classic and new biomarkers, only PSA has been of value for prediction of progression-free survival.

Key words:

Prostate cancer - Prognostic factors - Prostate-specific antigen

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PD Dr C G Fischer

Urologische KlinikJustus-Liebig Universität

Klinikstr. 2935385 Gießen

Phone: Tel. 0641-99-44501

Fax: Fax 0641-99-44509

Email: E-mail: claus.fischer@chiru.med.uni-giessen.de