{"id":7422,"date":"2025-05-07T18:21:56","date_gmt":"2025-05-07T16:21:56","guid":{"rendered":"https:\/\/family-medicine.org\/prostate-cancer-therapy\/"},"modified":"2025-05-09T10:13:02","modified_gmt":"2025-05-09T08:13:02","slug":"prostata-krebs-therapie","status":"publish","type":"post","link":"https:\/\/family-medicine.org\/de\/prostata-krebs-therapie\/","title":{"rendered":"\u00dcberwachung, Operation oder Strahlentherapie bei Prostatakrebs"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"7422\" class=\"elementor elementor-7422 elementor-7401\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-fbf95e6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fbf95e6\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-37109a6\" data-id=\"37109a6\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0017917 elementor-widget elementor-widget-text-editor\" data-id=\"0017917\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Diese im <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2214122\">NEJM<\/a> 2023 ver\u00f6ffentlicht randomisierte kontrollierte Studie (RCT) rekrutierte 1.643 Patienten aus Gro\u00dfbritannien im Alter von 50-69 Jahren mit lokalem Prostatakrebs. Sie erhielten entweder eine Prostatektomie, Radiotherapie oder aktives Monitoring. Nat\u00fcrlich konnten Patienten sp\u00e4ter die Behandlung wechseln (61% derjenigen unter aktiver \u00dcberwachung machten das). Nach einer medianen Nachbeobachtungszeit von <strong>15 Jahren<\/strong> verstarben <strong>356<\/strong> M\u00e4nner, davon jedoch \u201enur\u201c <strong>45<\/strong> an Prostatakrebs (13% der Todesf\u00e4lle). Zwischen den drei Behandlungsgruppen gab es <strong>keine signifikanten Unterschiede<\/strong> (P=0,53) bez\u00fcglich Todesf\u00e4lle durch Prostatakrebs:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f51fe90 elementor-widget elementor-widget-image\" data-id=\"f51fe90\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"923\" height=\"525\" src=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27.png\" class=\"attachment-large size-large wp-image-7426\" alt=\"\" srcset=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27.png 923w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27-300x171.png 300w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27-768x437.png 768w\" sizes=\"(max-width: 923px) 100vw, 923px\" data-attachment-id=\"7426\" data-permalink=\"https:\/\/family-medicine.org\/de\/bildschirmfoto-2025-05-07-um-18-28-27\/\" data-orig-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27.png\" data-orig-size=\"923,525\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Bildschirmfoto-2025-05-07-um-18.28.27\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.27.png\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-065d416 elementor-widget elementor-widget-text-editor\" data-id=\"065d416\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Andere Outcomes waren jedoch signifikant schlechter beim aktiven Monitoring im Vergleich zur Prostatektomie\/Radiotherapie. Konkret entwickelten sich <strong>Metastasen<\/strong> bei 9% vs. 5%, eine <strong>Androgendeprivationstherapie<\/strong> wurde bei 13% vs. 7% eingeleitet, und eine <strong>klinische Verschlechterung<\/strong> trat bei 26% vs. 11% auf.<\/p><p>Patientenberichtete <a href=\"https:\/\/evidence.nejm.org\/doi\/full\/10.1056\/EVIDoa2300018\">Outcomes<\/a> waren jedoch schlechter bei der radikalen Prostatektomie, insbesondere <strong>langfristige Harnwegs- und sexuelle Sch\u00e4den<\/strong>:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3841304 elementor-widget elementor-widget-image\" data-id=\"3841304\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"924\" height=\"526\" src=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44.png\" class=\"attachment-large size-large wp-image-7428\" alt=\"\" srcset=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44.png 924w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44-300x171.png 300w, https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44-768x437.png 768w\" sizes=\"(max-width: 924px) 100vw, 924px\" data-attachment-id=\"7428\" data-permalink=\"https:\/\/family-medicine.org\/de\/bildschirmfoto-2025-05-07-um-18-28-44\/\" data-orig-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44.png\" data-orig-size=\"924,526\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Bildschirmfoto-2025-05-07-um-18.28.44\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/family-medicine.org\/wp-content\/uploads\/2025\/05\/Bildschirmfoto-2025-05-07-um-18.28.44.png\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fd56400 elementor-widget elementor-widget-text-editor\" data-id=\"fd56400\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Die Autoren folgerten, dass \u201ePatienten, die neu mit lokalem Prostatakrebs diagnostiziert wurden, die <strong>Abw\u00e4gung<\/strong> zwischen den Behandlungssch\u00e4den und den Risiken des Fortschreitens des Prostatakrebses im Kontext der niedrigen krebsspezifischen Mortalit\u00e4t sorgf\u00e4ltig ber\u00fccksichtigen sollten\u201c.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Eine 15-j\u00e4hrige RCT zeigte keinen \u00dcberlebensvorteil zwischen \u00dcberwachung, Operation oder Strahlentherapie bei lokalisiertem Prostatakrebs, jedoch deutliche Unterschiede bei Progression und therapiebedingten Nebenwirkungen.<\/p>\n","protected":false},"author":93452803,"featured_media":7411,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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