[Certified prostate cancer centers of the German Cancer Society : Current status 2 years after certification and future developments]. / Zertifizierte Prostatakarzinomzentren der Deutschen Krebsgesellschaft : Aktueller Stand nach 2 Jahren Zertifizierung und künftige Entwicklungen.

The 12-month data for 21 of the 44 certified centers were analyzed 2 years after certification of the first prostate cancer centers of the German Cancer Society. Currently about 25% of patients with prostate cancer are being treated in the centers certified by the German Cancer Society. On the one hand, a positive development toward interdisciplinary management can be observed with verifiably good surgical quality in most of the centers and good outpatient care provided by social services, and in some instances psycho-oncological support. On the other hand, there are substantial problems with data documentation. The quality of documentation declines considerably when the patient leaves the hospital. Concerted efforts must be made to improve documentation of patient data and transfer of aftercare information. The association with hospital cancer registries must be enhanced. The quality of both inpatient care and intersectoral care can only be improved on a long-term basis when the insurance providers support this development. Only when there is evidence for improved treatment quality can the long-term development of centers be justified, but until this is corroborated the establishment of centers cannot remain without financing.

Serum levels of prostate specific antigen in men on hemodialysis.

UNLABELLED: The measurement of prostate specific antigen (PSA) is widely used for the early detection of prostate cancer. However the influence of renal failure on the serum levels of the PSA molecular forms is still a matter of investigation. We therefore examined the serum concentration of total and free PSA in patients undergoing hemodialysis and discuss the influence of renal failure on both types. MATERIALS AND METHODS: Serum concentrations of total PSA, free PSA and the free-to-total PSA ratio were measured in 48 men undergoing hemodialysis. Total and free PSA levels were measured employing a chemiluminescent enzyme immunoassay. RESULTS: Serum levels of total PSA, free PSA as well as the free-to-total PSA ratio did not change significantly in uremic patients after hemodialysis. Median total PSA concentration was 1.1 ng/mL before and 1.15 ng/mL after hemodialysis (p = 0.24); median free PSA concentration was 0.29 ng/mL before and 0.32 ng/mL after hemodialysis (p = 0.14). Median free-to-total PSA ratio was 0.29 ng/mL before and 0.31 ng/mL after hemodialysis (p = 0.66). CONCLUSION: Serum free PSA as well as total PSA is not eliminated by hemodialysis and the slightly elevated levels of free PSA and the free-to-total PSA ratio in uremic patients after hemodialysis may be caused by the concomitant decrease in binding proteins. We therefore conclude that the reference ranges for total PSA, free PSA and the f-/t-PSA ratio are applicable undergoing chronic hemodialysis.