{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T12:40:03Z","timestamp":1730810403183,"version":"3.28.0"},"reference-count":51,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n    Die kombinierte Androgendeprivation mit einem neuen Androgenrezeptor-Biosyntheseinhibitor, dem Zytostatikum Docetaxel oder der Kombination mit Abirateron\/Prednison plus Docetaxel bzw. Darolutamid plus Docetaxel stellen die Therapie der Wahl des metastasierten hormonsensitiven Prostatakarzinoms (mHSPC) dar. Trotz des meist guten Ansprechens hat diese Therapie nur einen palliativen Charakter und f\u00fchrt unweigerlich nach durchschnittlich 2,5\u20134 Jahren zur Entwicklung eines kastrationsresistenten Prostatakarzinoms (CRPC). In diesem Fall stehen neben der klassischen taxanbasierten Chemotherapie, die sekund\u00e4re Hormonablation, die Radionuklidtherapie mit Radium 223 oder 177Lu-PSMA als neuere Therapieverfahren zur Verf\u00fcgung. Aufgrund der dadurch \u2013 je nach Therapieansprechen \u2013 verl\u00e4ngerten \u00dcberlebenszeit gewinnen behandlungsw\u00fcrdige Komplikationen durch das lokal progrediente CRPC, Lokalrezidive oder pelvine Lymphknotenmetastasen zunehmend an Bedeutung.\n    <\/jats:p><jats:p>\n    Treten Komplikationen des unteren Harntrakts wie rezidivierende transfusionspflichtige Makroh\u00e4maturien mit oder ohne Blasentamponade, eine subvesikale Obstruktion mit der Notwendigkeit einer Harnableitung oder rektourethrale\/rektovesikale Fisteln auf, stehen als palliative chirurgische Therapieoptionen die palliative TUR-P, die radikale (Zysto-)Prostatektomie mit entsprechender Harnableitung sowie die posteriore Exenteration bei rektaler Infiltration zur Verf\u00fcgung. Bei Harnstauungsnieren aufgrund einer supravesikalen Obstruktion stehen je nach Erlebenserwartung und Allgemeinzustand des Patienten die Anlage einer endoluminalen Ureterschiene oder perkutanen Nephrostomie sowie chirurgisch rekonstruktive Ma\u00dfnahmen wie die Ureterneuimplantation, Ureter-Ileum-Interponat oder Implantation eines Detour-Systems als Therapieoptionen zur Verf\u00fcgung.\n    <\/jats:p><jats:p>\n    Letztlich stellt die palliative Tumorchirurgie ein individuelles Therapiekonzept dar, welches bei sorgf\u00e4ltiger Patientenselektion und ad\u00e4quater chirurgischer Expertise zu einer Verbesserung der Lebensqualit\u00e4t und lokalen Tumorkontrolle f\u00fchren kann.\n    <\/jats:p>","DOI":"10.1055\/a-2226-9243","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T23:42:55Z","timestamp":1705534975000},"page":"139-147","source":"Crossref","is-referenced-by-count":0,"title":["Palliative Urologische Chirurgie des metastasierten Prostatakarzinoms: was m\u00fcssen wir zuk\u00fcnftig ber\u00fccksichtigen?"],"prefix":"10.1055","volume":"55","author":[{"given":"Axel","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universit\u00e4tsklinikum K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Bach","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universit\u00e4tsklinikum K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Pfister","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universit\u00e4tsklinikum K\u00f6ln, K\u00f6ln, 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