Publikationsserver der Universitätsbibliothek Marburg

Titel: Der Lymphknotenstatus beim Prostatakarzinom - Korrelationen mit präoperativen Parametern und prognostischen Endpunkten unter besonderer Berücksichtigung der Lymphknotendichte
Autor: Hoffmann, Jonas
Weitere Beteiligte: Olbert, Peter (Dr.)
Veröffentlicht: 2011
URI: https://archiv.ub.uni-marburg.de/diss/z2012/0023
DOI: https://doi.org/10.17192/z2012.0023
URN: urn:nbn:de:hebis:04-z2012-00231
DDC: Medizin
Titel(trans.): Lymph node metastasis in prostate cancer - correlations with pre-operative parameters and prognostic end-points with special regard to lymph node density
Publikationsdatum: 2012-02-16
Lizenz: https://rightsstatements.org/vocab/InC-NC/1.0/

Dokument

Schlagwörter:
Prostatakrebs, Lymphknotendichte, Lymph node density, Lymphknoten

Zusammenfassung:
Das Prostatakarzinom ist die vierthäufigste Krebserkrankung des Mannes weltweit. In der männlichen Bevölkerung Westeuropas und Nordamerikas hat es die höchste Inzidenz und die zweithöchste Letalität aller malignen Tumore. Standardtherapie bei lokal begrenztem Prostatakarzinom ist die radikale Prostatektomie mit pelviner Lymphadenektomie, so dass eine mögliche Lymphknoteninfiltration detektiert werden kann. Lymphknotenmetastasen sind anerkanntermaßen ein schlechtes prognostisches Zeichen. Bislang wurde unterschieden zwischen N0- und N1-Status, diese Einteilung scheint durch die Nichtberücksichtigung von ergänzender Information zur differenzierten Betrachtung der Prognose jedoch zu einfach zu sein. Trotz großer Fortschritte, die in den letzten Jahren in der Diagnostik und Therapie erreicht wurden, bleiben viele Fragen offen. Diese betreffen unter anderem die Bedeutung von verschiedenen Ausprägungen der Lymphknotenmetastasierung zur Prognosestellung. Ziel der vorliegenden Arbeit war, einerseits zu zeigen, inwiefern präoperativ erhobene Parameter eine Lymphknotenmetastasierung vorhersagen können und andererseits, welche einzelnen Faktoren bei positivem Lymphknotenstatus die prognostischen Endpunkte beeinflussen. 913 Patienten des Universitätsklinikums Marburg wurden retrospektiv untersucht, 99 Patienten zeigten histologisch gesicherte Lymphknotenmetastasen (10,84%). Der mittlere Nachbeobachtungszeitraum betrug 51 Monate nach radikaler Prostatektomie. Zur Erfassung der Patientendaten und zur statistischen Analyse wurde eine Datenbank mit der Software SPSS erstellt. Die Möglichkeit der Vorhersage einer Lymphknotenmetastasierung durch prätherapeutisch erhobene Daten zu klinischem Stadium, PSA-Wert und Gleason-Score konnte für jeden Wert einzeln als auch in der multivariaten Analyse mit hochsignifikanten Werten bestätigt werden (p<0,001). In einem zweiten Teil wurde der pN-Status, sowie differenzierte Information wie extranodales Tumorwachstum, Lymphknotendichte und absolute Anzahl der entnommenen Lymphknoten mit den prognostischen Parametern Gesamtüberleben, rezidivfreies Überleben, rezidivfreies Intervall und karzinomspezifische Mortalität korreliert. Hierzu wurden Kreuztabellen, statistische Tests und Kaplan-Meier-Kurven erstellt. Für das Gesamtüberleben konnten hinsichtlich des Lymphknotenstatus keine Abhängigkeiten gezeigt werden. Tendenzen konnten durch die Zusammenschau mit Komorbiditäten erkannt werden. Hingegen konnte nachgewiesen werden, dass der Lymphknotenstatus signifikant mit der Rezidivhäufigkeit korrelierte (p=0,046). Die rezidivfreie Überlebenszeit korrelierte bei hier untersuchtem Patientenkollektiv und vorhandenem Nachbeobachtungszeitraum mit keinem der untersuchten Parameter signifikant. Bedingt durch die langsam progrediente Natur des Prostatakarzinoms war in der vorliegenden Arbeit wohl vor allem der Nachbeobachtungszeitraum zu kurz und die einzelnen Patientengruppen zu klein, um für diese Fragestellungen signifikante Ergebnisse zu erhalten. So sind spezifisch an ihrem Prostatakarzinom nur zwei der 913 Patienten gestorben, diese waren beide lymphknotenpositiv. Die Kontinenzzufriedenheit hing von der Operationstechnik ab, mit dem Lymphknotenstatus beziehungsweise einer adjuvanten Therapie war der Nachweis einer Korrelation nicht zu führen. Zusammenfassend konnte in dieser Arbeit die Korrelation von präoperativen Parametern mit einem positiven Lymphknotenstatus eindeutig bestätigt werden. Für die untersuchten prognostischen Parameter waren einige Tendenzen zu erkennen, die in künftigen prospektiven Studien mit sehr großen Patientenzahlen und langen Nachbeobachtungszeiträumen genauer analysiert werden sollten. Die für die vorliegende Arbeit erstellte Datenbank mit dem Patientengut des Universitätsklinikums Marburg wird auch in Zukunft gepflegt und um alle hier behandelten Prostatakarzinompatienten ergänzt werden, so dass an diesem Standort künftig weitere retrospektive Studien mit längeren Nachbeobachtungszeiträumen und größeren Patientenkollektiven möglich sein werden.

Summary:
Globally, prostate cancer is the fourth most common male malignant neoplasm. In the male population of Western Europe and North America it claims the highest incidence and the second most common cause of lethality of all malignant tumors. In early stage disease, therapy of choice is radical prostatectomy including pelvic lymphadenectomy to detect metastatic spread to the lymph nodes. It is well acknowledged that the presence of lymph node metastasis is a poor prognostic sign. Up to now, it was distinguished between N0- and N1-status, this classification seems to be too simple for a differentiated consideration of prognosis. In recent years, great advances in diagnosis and treatment have been achieved, however, many questions remain. Amongst others, these questions concern the impact on prognosis of different characteristics of lymph node metastasis. The purpose of this study was, on the one hand, to determine the predictability of lymph node metastasis by the use of preoperative surveyed parameters and on the other hand, to show which single factors in positive lymph nodes affect prognostic endpoints. 913 patients from the Department of Urology, University Medical Center Marburg were analyzed retrospectively, 99 patients showed histologically proven lymph node metastasis (10,84%). Median follow-up was 51 months after radical prostatectomy. A data base with the SPSS software was established for the aquisition and statistical analysis of the patients parameters. The evidence for the ability of prediction of lymph node infiltration by the use of the pretherapeutic surveyed parameters clinical stage, PSA and Gleason-Score was clearly shown for each single factor and in multivariate analysis, too, with highly significant values (p<0,001). In a second part of this study, the correlation of the pN-status as well as the different specifications of lymph node metastasis like extranodal growth, lymph node density and absolute lymph node count on the one hand and the prognostic parameters survival, recurrence-free survival, recurrence-free interval and cancer-specific mortality on the other hand, was examined. Therefor, tables, statistical tests and Kaplan-Meier survival estimates were created. Overall survival was not dependent on the pN-status. In synopsis with comorbidities, tendencies were observable. The lymph node status correlated significantly with the frequency of disease recurrence (p=0,046). In the analyzed study cohort and with the given follow-up, time to progression was not correlating significantly with any of the examined parameters. Caused by the nature of slow progredience of prostate cancer, in this study, the follow-up was too short and the particular groups of patients were too small to achieve significant results concerning these questions. Only two out of the 913 patients died specifically by prostate cancer, both of them had positive lymph nodes. The contentment with continence was dependent on surgical technique, there was no evident correlation to lymph node spread and adjuvant therapy, respectively. In summary, the correlation between preoperative parameters and positive lymph nodes could clearly be affirmed. With regard to the examined prognostic parameters, there were tendencies identifiable. Henceforth, there is necessity of accurate evaluation of these parameters in prospective studies with long follow-up-intervals and very big patient numbers. The data base containing the prostate cancer patients of the University Marburg established for this study, will be administered and enlarged with all patients operated in this department in the future, so that there will be possibility of accomplishment of further studies with longer follow-ups and increased patient numbers.

Bibliographie / References

  1. Pagliarulo, V., D. Hawes, et al. (2006). "Detection of occult lymph node metastases in locally advanced node-negative prostate cancer." J Clin Oncol 24(18): 2735-42.
  2. Mattei, A., F. G. Fuechsel, et al. (2008). "The template of the primary lymphatic landing sites of the prostate should be revisited: results of a multimodality mapping study." Eur Urol 53(1): 118-25.
  3. Mistry K, Cable G. (2003). "Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma". J Am Board Fam Pract;16(2):95-101.
  4. Hoogendam A, Buntinx F, de Vet HC (1999). "The diagnostic value of digital rectal examination in primary care screening for prostate cancer: a meta-analysis". Fam Pract;16(6):621-6.
  5. Sutcliffe, Hummel, Simpson, Young, Rees, Wilkinson, Hamdy, Clarke, Staffurth (2009). "Use of classical and novel biomarkers as prognostic risk factors for localised prostate cancer: a systematic review" Health Technology Assessment 13: 5
  6. Isbarn, H., J. H. Pinthus, et al. (2009). "Testosterone and Prostate Cancer: Revisiting Old Paradigms." Eur Urol.
  7. Harisinghani, M. G., J. Barentsz, et al. (2003). "Noninvasive detection of clinically occult lymph-node metastases in prostate cancer." N Engl J Med 348(25): 2491- 9.
  8. Wang, M. C., L. A. Valenzuela, et al. (1979). "Purification of a human prostate specific antigen." Invest Urol 17(2): 159-63.
  9. Penson, D. F., D. McLerran, et al. (2005). "5-year urinary and sexual outcomes after radical prostatectomy: results from the prostate cancer outcomes study." J Urol 173(5): 1701-5.
  10. Ross, P. L., P. T. Scardino, et al. (2001). "A catalog of prostate cancer nomograms." J Urol 165(5): 1562-8.
  11. Miller, K., M. Lein, et al. (2008). "[Adjuvant and neoadjuvant drug therapy for prostate cancer]." Urologe A 47(11): 1460-4.
  12. Weingartner, K., A. Ramaswamy, et al. (1996). "Anatomical basis for pelvic lymphadenectomy in prostate cancer: results of an autopsy study and implications for the clinic." J Urol 156(6): 1969-71.
  13. Walsh, P. C. (1998). "Anatomic radical prostatectomy: evolution of the surgical technique." J Urol 160(6 Pt 2): 2418-24.
  14. McNeal, J. E. (1984). "Anatomy of the prostate and morphogenesis of BPH." Prog Clin Biol Res 145: 27-53.
  15. Grant, W. B. (1999). "An ecologic study of dietary links to prostate cancer." Altern Med Rev 4(3): 162-9.
  16. Porter, C. R., N. Suardi, et al. (2008). "A nomogram predicting metastatic progression after radical prostatectomy." Int J Urol 15(10): 889-94.
  17. Kattan, M. W., J. A. Eastham, et al. (1998). "A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer." J Natl Cancer Inst 90(10): 766-71.
  18. Gann, P. H., C. H. Hennekens, et al. (1995). "A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer." JAMA 273(4): 289- 94.
  19. Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU Int 2003;91(9):789-94.
  20. Helpap, B. and J. Kollermann (1999). "Atypical acinar proliferations of the prostate." Pathol Res Pract 195(12): 795-9.
  21. Mintz ER, S. G. (1934). "Autopsy findings in 100 cases of prostatic cancer." N Engl J Med 211: 479-487.
  22. Graefen, M., U. Pichlmeier, et al. (2000). "A validated strategy to select patients for a nerve-sparing radical prostatectomy." Prostate Cancer Prostatic Dis 3(S1): S18.
  23. Paulson, D. F. (1984). "Carcinoma of the prostate: the therapeutic dilemma." Annu Rev Med 35: 341-72.
  24. Kawakami, J., M. V. Meng, et al. (2006). "Changing patterns of pelvic lymphadenectomy for prostate cancer: results from CaPSURE." J Urol 176(4 Pt 1): 1382-6.
  25. Lotan, T., Epstein, J (2010). " Clinical implications of changing definitions within the Gleason grading system." Nature Reviews Urology 7: 136-142
  26. Grimm, M. O., S. Kamphausen, et al. (2002). "Clinical outcome of patients with lymph node positive prostate cancer after radical prostatectomy versus androgen deprivation." Eur Urol 41(6): 628-34; discussion 634.
  27. Morganti, G., L. Gianferrari, et al. (1956). "[Clinico-statistical and genetic research on neoplasms of the prostate.]." Acta Genet Stat Med 6(2): 304-5.
  28. Partin, A. W., L. A. Mangold, et al. (2001). "Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium." Urology 58(6): 843-8.
  29. Shen, B. Y., K. H. Tsui, et al. (2003). "Correlation between the Gleason scores of needle biopsies and radical prostatectomy specimens." Chang Gung Med J 26(12): 919-24.
  30. Kupelian, P., J. Katcher, et al. (1996). "Correlation of clinical and pathologic factors with rising prostate-specific antigen profiles after radical prostatectomy alone for clinically localized prostate cancer." Urology 48(2): 249-60.
  31. Pisansky, T. M., H. Zincke, et al. (1996). "Correlation of pretherapy prostate cancer characteristics with histologic findings from pelvic lymphadenectomy specimens." Int J Radiat Oncol Biol Phys 34(1): 33-9.
  32. Gomella, L. G., J. Johannes, et al. (2009). "Current prostate cancer treatments: effect on quality of life." Urology 73(5 Suppl): S28-35.
  33. Swanson, G. P., I. M. Thompson, et al. (2006). "Current status of lymph node-positive prostate cancer: Incidence and predictors of outcome." Cancer 107(3): 439-50.
  34. Koksal, I. T., F. Ozcan, et al. (2000). "Discrepancy between Gleason scores of biopsy and radical prostatectomy specimens." Eur Urol 37(6): 670-4.
  35. Kroepfl, D., H. Loewen, et al. (2006). "Disease progression and survival in patients with prostate carcinoma and positive lymph nodes after radical retropubic prostatectomy." BJU Int 97(5): 985-91.
  36. Heidenreich, A., G. Aus, et al. (2008). "EAU guidelines on prostate cancer." Eur Urol 53(1): 68-80.
  37. Lonn, E., J. Bosch, et al. (2005). "Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial." JAMA 293(11): 1338-47.
  38. Nakashima J, Tanimoto A, Imai Y, Mukai M, Horiguchi Y, Nakagawa K, Oya M, Ohigashi T, Marumo K, Murai M (2004). "Endorectal MRI for prediction of tumor site, tumor size, and local extension of prostate cancer". Urology;64(1):101-5.
  39. Golimbu, M., P. Morales, et al. (1979). "Extended pelvic lymphadenectomy for prostatic cancer." J Urol 121(5): 617-20.
  40. Heidenreich, A., Z. Varga, et al. (2002). "Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis." J Urol 167(4): 1681-6.
  41. Humphrey, P. A. (2004). "Gleason grading and prognostic factors in carcinoma of the prostate." Mod Pathol 17(3): 292-306.
  42. Schumacher, M. C., F. C. Burkhard, et al. (2008). "Good outcome for patients with few lymph node metastases after radical retropubic prostatectomy." Eur Urol 54(2): 344-52.
  43. Gray, Ed. (1918). Gray´s Anatomy of the Human Body. Literaturverzeichnis ______________________________________________________________________ 118
  44. Thompson, I., J. B. Thrasher, et al. (2007). "Guideline for the management of clinically localized prostate cancer: 2007 update." J Urol 177(6): 2106-31.
  45. A. Heidenreich (chairman), M. Bolla, S. Joniau, M.D. Mason, V. Matveev, N. Mottet, H-P. Schmid, T.H. van der Kwast, T. Wiegel, F. Zattoni (2010). "Guidelines on Prostate Cancer" Online guideline Heidenreich, A., C. H. Ohlmann, et al. (2007). "Anatomical extent of pelvic lymphadenectomy in patients undergoing radical prostatectomy." Eur Urol 52(1): 29-37.
  46. Schmeller, N., H. Keller, et al. (2007). "Head-to-head comparison of retropubic, perineal and laparoscopic radical prostatectomy." Int J Urol 14(5): 402-5.
  47. Laudano, M. A., S. M. Lambert, et al. (2009). "How often do available preoperative risk factors accurately predict the risk assessed after surgery for localized prostate cancer?" BJU Int 103(3): 317-20.
  48. Messing, E. M., J. Manola, et al. (1999). "Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer." N Engl J Med 341(24): 1781-8.
  49. Joslyn, S. A. and B. R. Konety (2006). "Impact of extent of lymphadenectomy on survival after radical prostatectomy for prostate cancer." Urology 68(1): 121-5.
  50. Loblaw DA, Virgo KS, Nam R, Somerfield MR, Ben-Josef E, Mendelson DS, Middleton R, Sharp SA, Smith TJ, Talcott J, Taplin M, Vogelzang NJ, Wade JL,3rd, Bennett CL, Scher HI, American Society of Clinical Oncology. Initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer: 2006 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol 2007;25(12):1596-605.
  51. Schumacher, M. C., F. C. Burkhard, et al. (2006). "Is pelvic lymph node dissection necessary in patients with a serum PSA<10ng/ml undergoing radical prostatectomy for prostate cancer?" Eur Urol 50(2): 272-9.
  52. Ohori, M., J. K. Dunn, et al. (1995). "Is prostate-specific antigen density more useful than prostate-specific antigen levels in the diagnosis of prostate cancer?" Urology 46(5): 666-71.
  53. Weight, C. J., A. M. Reuther, et al. (2008). "Limited pelvic lymph node dissection does not improve biochemical relapse-free survival at 10 years after radical prostatectomy in patients with low-risk prostate cancer." Urology 71(1): 141-5.
  54. Zincke, H., J. E. Oesterling, et al. (1994). "Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer." J Urol 152(5 Pt 2): 1850-7.
  55. Han, M., A. W. Partin, et al. (2001). "Long-term biochemical disease-free and cancer- specific survival following anatomic radical retropubic prostatectomy. The 15- year Johns Hopkins experience." Urol Clin North Am 28(3): 555-65.
  56. Seay, T. M., M. L. Blute, et al. (1998). "Long-term outcome in patients with pTxN+ adenocarcinoma of prostate treated with radical prostatectomy and early androgen ablation." J Urol 159(2): 357-64.
  57. Petros, J. A. and W. J. Catalona (1992). "Lower incidence of unsuspected lymph node metastases in 521 consecutive patients with clinically localized prostate cancer." J Urol 147(6): 1574-5.
  58. Flocks, R. H., D. Culp, et al. (1959). "Lymphatic spread from prostatic cancer." J Urol 81(1): 194-6.
  59. Ordon, M. and R. K. Nam (2009). "Lymph node assessment and lymphadenectomy in prostate cancer." J Surg Oncol 99(4): 215-24.
  60. Kassouf, W., P. K. Agarwal, et al. (2008). "Lymph node density is superior to TNM nodal status in predicting disease-specific survival after radical cystectomy for bladder cancer: analysis of pooled data from MDACC and MSKCC." J Clin Oncol 26(1): 121-6.
  61. Zwergel, U., J. Lehmann, et al. (2004). "Lymph node positive prostate cancer: long- term survival data after radical prostatectomy." J Urol 171(3): 1128-31.
  62. Swindle, P. W., M. W. Kattan, et al. (2003). "Markers and meaning of primary treatment failure." Urol Clin North Am 30(2): 377-401.
  63. Saitoh, H., M. Hida, et al. (1984). "Metastatic patterns of prostatic cancer. Correlation between sites and number of organs involved." Cancer 54(12): 3078-84.
  64. Shand, R. L. and E. P. Gelmann (2006). "Molecular biology of prostate-cancer pathogenesis." Curr Opin Urol 16(3): 123-31.
  65. Nupponen, N. N. and T. Visakorpi (2000). "Molecular cytogenetics of prostate cancer." Microsc Res Tech 51(5): 456-63.
  66. Katz, S. and M. Rosen (2006). "MR imaging and MR spectroscopy in prostate cancer management." Radiol Clin North Am 44(5): 723-34, viii. Literaturverzeichnis ______________________________________________________________________ 121
  67. Heesakkers, R. A., A. M. Hovels, et al. (2008). "MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients Literaturverzeichnis ______________________________________________________________________ 119 with prostate cancer: a prospective multicohort study." Lancet Oncol 9(9): 850- 6.
  68. Pound, C. R., A. W. Partin, et al. (1999). "Natural history of progression after PSA elevation following radical prostatectomy." JAMA 281(17): 1591-7.
  69. Scolieri, M. J., A. Altman, et al. (2000). "Neoadjuvant hormonal ablative therapy before radical prostatectomy: a review. Is it indicated?" J Urol 164(5): 1465-72.
  70. Cunéo, B. and Marcille, M. (1901). "Note sur les lymphatiques de la vessie." Bull Mem Soc Anat 6: 649.
  71. Patientenfragebogen Nachsorge nach radikaler Prostatektomie Name: Vorname: Geburtsdatum:_________________
  72. Jeldres, C., J. B. Latouff, et al. (2009). "Predicting life expectancy in prostate cancer patients." Curr Opin Support Palliat Care.
  73. Hu, J. C., E. P. Elkin, et al. (2004). "Predicting quality of life after radical prostatectomy: results from CaPSURE." J Urol 171(2 Pt 1): 703-7; discussion 707-8.
  74. Roach, M., 3rd, C. Marquez, et al. (1994). "Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and Gleason score in men with clinically localized prostate cancer." Int J Radiat Oncol Biol Phys 28(1): 33-7.
  75. Nguyen, P. L., M. H. Chen, et al. (2009). "Predicting the risk of pelvic node involvement among men with prostate cancer in the contemporary era." Int J Radiat Oncol Biol Phys 74(1): 104-9.
  76. Gleason, D. F. and G. T. Mellinger (1974). "Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging." J Urol 111(1): 58-64.
  77. Okotie, O. T., W. J. Aronson, et al. (2004). "Predictors of metastatic disease in men with biochemical failure following radical prostatectomy." J Urol 171(6 Pt 1): 2260-4.
  78. Naselli, A., R. Andreatta, et al. (2009). "Predictors of Symptomatic Lymphocele After Lymph Node Excision and Radical Prostatectomy." Urology.
  79. Flocks, R. H., D. A. Culp, et al. (1959). "Present status of radioactive gold therapy in management of prostatic cancer." J Urol 81(1): 178-84.
  80. Hofer, M. D., R. Kuefer, et al. (2006). "Prognostic factors in lymph node-positive prostate cancer." Urology 67(5): 1016-21.
  81. Griebling, T. L., D. Ozkutlu, et al. (1997). "Prognostic implications of extracapsular extension of lymph node metastases in prostate cancer." Mod Pathol 10(8): 804- 9.
  82. Gervasi, L. A., J. Mata, et al. (1989). "Prognostic significance of lymph nodal metastases in prostate cancer." J Urol 142(2 Pt 1): 332-6.
  83. Quinn, D. I., S. M. Henshall, et al. (2003). "Prognostic significance of preoperative factors in localized prostate carcinoma treated with radical prostatectomy: Literaturverzeichnis ______________________________________________________________________ 126 importance of percentage of biopsies that contain tumor and the presence of biopsy perineural invasion." Cancer 97(8): 1884-93.
  84. Soderdahl, D. W., J. W. Davis, et al. (2005). "Prospective longitudinal comparative study of health-related quality of life in patients undergoing invasive treatments for localized prostate cancer." J Endourol 19(3): 318-26.
  85. Gil-Vernet, J. M. (1996). "Prostate cancer: anatomical and surgical considerations." Br J Urol 78(2): 161-8.
  86. Penson, D. F., M. Rossignol, et al. (2008). "Prostate cancer: epidemiology and health- related quality of life." Urology 72(6 Suppl): S3-11.
  87. Wang, L., M. Mullerad, et al. (2004). "Prostate cancer: incremental value of endorectal MR imaging findings for prediction of extracapsular extension." Radiology 232(1): 133-9.
  88. Gronau, E., M. Goppelt, et al. (2005). "Prostate cancer relapse after therapy with curative intention: a diagnostic and therapeutic dilemma." Onkologie 28(6-7): 361-6.
  89. Tan, N., B. R. Lane, et al. (2008). "Prostate cancers diagnosed at repeat biopsy are smaller and less likely to be high grade." J Urol 180(4): 1325-9; discussion 1329.
  90. Moul, J. W., V. Mouraviev, et al. (2009). "Prostate cancer: the new landscape." Curr Opin Urol 19(2): 154-60.
  91. Spencer, J. A., W. J. Chng, et al. (1998). "Prostate specific antigen level and Gleason score in predicting the stage of newly diagnosed prostate cancer." Br J Radiol 71(851): 1130-5.
  92. Palapattu, G. S., M. E. Allaf, et al. (2004). "Prostate specific antigen progression in men with lymph node metastases following radical prostatectomy: results of long- term followup." J Urol 172(5 Pt 1): 1860-4.
  93. Sun, L., J. W. Moul, et al. (2007). "Prostate-specific antigen (PSA) and PSA velocity for prostate cancer detection in men aged <50 years." BJU Int 99(4): 753-7.
  94. Gretzer, M. B. and A. W. Partin (2003). "PSA markers in prostate cancer detection." Urol Clin North Am 30(4): 677-86.
  95. Parra, R. O., S. Isorna, et al. (1996). "Radical perineal prostatectomy without pelvic lymphadenectomy: selection criteria and early results." J Urol 155(2): 612-5.
  96. Kupelian, P. A., L. Potters, et al. (2004). "Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer." Int J Radiat Oncol Biol Phys 58(1): 25-33.
  97. Gomez, P., M. Manoharan, et al. (2004). "Radionuclide bone scintigraphy in patients with biochemical recurrence after radical prostatectomy: when is it indicated?" BJU Int 94(3): 299-302.
  98. Partin, A. W. and P. C. Walsh (1994). "Re: The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer." J Urol 152(1): 172-3.
  99. Millin, T. (Retropubic prostatectomy: a new extravesical technique report on 20 cases.).
  100. Schlomm, T., C. Borgermann, et al. (2009). "[Role of lymphnode dissection in prostate cancer]." Urologe A 48(1): 37-45.
  101. Schröder, F.H., Hugosson, J. M.J. Roobol, et al. (2009). "Screening and prostate-cancer mortality in a randomized European study". N Engl J Med 360 (1320 -1328) Literaturverzeichnis ______________________________________________________________________ 127
  102. Weckermann, D., G. Holl, et al. (2007). "[Sentinel node dissection in prostate cancer: current status]." Urologe A 46(11): 1500-7.
  103. Oesterling, J. E., S. J. Jacobsen, et al. (1993). "Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges." JAMA 270(7): 860-4.
  104. Jewett, H. J. (1956). "Significance of the palpable prostatic nodule." J Am Med Assoc 160(10): 838-9.
  105. Kupelian, P. A., J. Katcher, et al. (1997). "Stage T1-2 prostate cancer: a multivariate analysis of factors affecting biochemical and clinical failures after radical prostatectomy." Int J Radiat Oncol Biol Phys 37(5): 1043-52.
  106. Wilkinson, B. A. and F. C. Hamdy (2001). "State-of-the-art staging in prostate cancer." BJU Int 87(5): 423-30.
  107. Herr, H. W. (2003). "Superiority of ratio based lymph node staging for bladder cancer." J Urol 169(3): 943-5.
  108. Ravery, V., L. A. Boccon-Gibod, et al. (1994). "Systematic biopsies accurately predict extracapsular extension of prostate cancer and persistent/recurrent detectable PSA after radical prostatectomy." Urology 44(3): 371-6.
  109. Greene, F. L. (2002). "The American Joint Committee on Cancer: updating the strategies in cancer staging." Bull Am Coll Surg 87(7): 13-5.
  110. Young, HH. (1905). "The early diagnosis and radical cure of carcinoma of the prostate. Being a study of 40 cases and presentation of a radical operation which was carried out in 4 cases." J Urol 2002 168: 914-921.
  111. Sakr, W. A., G. P. Haas, et al. (1993). "The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients." J Urol 150(2 Pt 1): 379-85.
  112. Murphy, A. M., D. S. Berkman, et al. (2009). "The number of negative pelvic lymph nodes removed does not affect the risk of biochemical failure after radical prostatectomy." BJU Int.
  113. Tindall DJ, Rittmaster RS, (2008). The ratio-nale for inhibiting 5a-reductase isoenzy-mes in the prevention and treatment of prostate cancer. J Urol 179:1235-1242.
  114. Wagner, M., M. Sokoloff, et al. (2008). "The role of pelvic lymphadenectomy for prostate cancer--therapeutic?" J Urol 179(2): 408-13.
  115. Wolf, J. S., Jr., M. Cher, et al. (1995). "The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy." J Urol 153(3 Pt 2): 993-9.
  116. Mukamel, E., J. Hannah, et al. (1986). "The value of computerized tomography scan and magnetic resonance imaging in staging prostatic carcinoma: comparison with the clinical and histological staging." J Urol 136(6): 1231-3.
  117. Perner,S., Schmidt, F.H., Hofer, M.D., Kuefer, R., Rubin, M. (2007). "TMPRSS2-ETS- gene fusion in prostate cancer." Der Urologe 46(7):754-760
  118. Wittekind, Meyer: TNM: Klassifikation maligner Tumoren. 7. Auflage 2010
  119. Nozaki, T., K. Yasuda, et al. (2008). "Usefulness of single photon emission computed tomography imaging in the detection of lumbar vertebral metastases from prostate cancer." Int J Urol 15(6): 516-9.
  120. Hedrick, L. and J. I. Epstein (1989). "Use of keratin 903 as an adjunct in the diagnosis of prostate carcinoma." Am J Surg Pathol 13(5): 389-96.
  121. Prasad, S. M., N. L. Keating, et al. (2008). "Variations in surgeon volume and use of pelvic lymph node dissection with open and minimally invasive radical prostatectomy." Urology 72(3): 647-52; discussion 652-3.
  122. Wann genau wurde bei Ihnen die Radikal-Operation der Prostata durchgeführt? Monat Jahr
  123. Welcher Urologe oder Hausarzt betreut sie derzeit im Rahmen der Nachsorge? bitte Namen und Ort angeben
  124. Parker, C. (2004). "Active surveillance: towards a new paradigm in the management of early prostate cancer." Lancet Oncol 5(2): 101-6.
  125. Lund, L., M. Borre, et al. (2008). "Impact of comorbidity on survival of Danish prostate cancer patients, 1995-2006: a population-based cohort study." Urology 72(6): 1258-62.
  126. Stephenson, A. J., S. F. Shariat, et al. (2004). "Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy." JAMA 291(11): 1325-32.
  127. Scott M. Lippman; Eric A. Klein; Phyllis J. Goodman; et al. (2009). "Effect of Selenium and Vitamin E on Risk of Prostate Cancer and Other Cancers: The Selenium and Vitamin E Cancer Prevention Trial (SELECT)" JAMA. 301(1):39-51
  128. Taneja, S. S. (2004). "Imaging in the diagnosis and management of prostate cancer." Rev Urol 6(3): 101-13.
  129. Masterson, T. A., F. J. Bianco, Jr., et al. (2006). "The association between total and positive lymph node counts, and disease progression in clinically localized prostate cancer." J Urol 175(4): 1320-4; discussion 1324-5.
  130. Makarov, D. V., B. J. Trock, et al. (2007). "Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005." Urology 69(6): 1095-101.
  131. Society, A. C. (2007). Cancer Facts and Figures 2007.
  132. Wong, Y. N., S. Freedland, et al. (2009). "Role of androgen deprivation therapy for node-positive prostate cancer." J Clin Oncol 27(1): 100-5.
  133. Simone, N. L., A. K. Singh, et al. (2008). "Pretreatment predictors of death from other causes in men with prostate cancer." J Urol 180(6): 2447-51; discussion 2451-2.
  134. Gurel, B., T. Iwata, et al. (2008). "Molecular alterations in prostate cancer as diagnostic, prognostic, and therapeutic targets." Adv Anat Pathol 15(6): 319-31.
  135. Nelson, W. G. (2007). "Prostate cancer prevention." Curr Opin Urol 17(3): 157-67.
  136. Tomlins SA, Rhodes DR, Perner S, Dhanasekaran SM, Mehra R, Sun XW, Varambally S, Cao X, Tchinda J, Kuefer R, Lee C, Montie JE, Shah RB, Pienta KJ, Rubin MA, Chinnaiyan AM (2005). "Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer. Science 28;310(5748):644-8
  137. Wawroschek, F., H. Vogt, et al. (2003). "Prostate lymphoscintigraphy and radio-guided surgery for sentinel lymph node identification in prostate cancer. Technique and results of the first 350 cases." Urol Int 70(4): 303-10.
  138. Zeegers MP, Jellema A, Ostrer H. Empiric risk of prostate carcinoma for relatives of patients with prostate carcinoma: a meta-analysis. Cancer 2003;97(8):1894-903.


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