Volker Rohde’s research while affiliated with University of Giessen and other places

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Publications (50)


Figure 1: Sexual functioning (IIEF). Mean scores of nnsRP, nsRP, and RT cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (solid line: nnsRP, dashed line: nsRP, dotted line: RT).
Table 1 Sociodemographic characteristics and tumor specific data
Figure 2: Health-related QoL (QLQ-C30). Mean scores of nnsRP, nsRP, and RT cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (solid line: nnsRP, dashed line: nsRP, dotted line: RT).
Table 2 Estimated effect of treatment option on HRQOL in a multiple regression analysis
Figure 3: PORPUS-P. Mean scores of nnsRP, nsRP, and RT cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (solid line: nnsRP, dashed line: nsRP, dotted line: RT).
The ProCaSP study: Quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study Urological oncology
  • Article
  • Full-text available

April 2015

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139 Reads

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19 Citations

BMC Urology

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This study describes and compares health-related quality of life (HRQOL) of prostate cancer patients who received either radical prostatectomy (nerve-sparing, nsRP, or non-nerve-sparing, nnsRP) or radiotherapy (external RT, brachytherapy, or both combined) for treatment of localised prostate cancer. The prospective, multicenter cohort study included 529 patients. Questionnaires included the IIEF, QLQ-C30, and PORPUS-P. Data were collected before (baseline), three, six, twelve, and twenty-four months after treatment. Differences between groups' baseline characteristics were assessed; changes over time were analysed with generalised estimating equations (GEE). Missing values were treated with multiple imputation. Further, scores at baseline and end of follow-up were compared to German reference data. The typical time trend was a decrease of average HRQOL three months after treatment followed by (partial) recovery. RP patients experienced considerable impairment in sexual functioning. The covariate-adjusted GEE identified a significant - but not clinically relevant - treatment effect for diarrhoea (b = 7.0 for RT, p = 0.006) and PORPUS-P (b = 2.3 for nsRP, b = 2.2 for RT, p = 0.045) compared to the reference nnsRP. Most of the HRQOL scores were comparable to German norm values. Findings from previous research were reproduced in a specific setting of a patient cohort in the German health care system. According to the principle of evidence-based medicine, this strengthens the messages regarding treatment in prostate cancer and its impacts on patients' health-related quality of life. After adjustment for baseline HRQOL and other covariates, RT patients reported increased symptoms of diarrhoea, and nnsRP patients decreased prostate-specific HRQOL. RP patients experienced considerable impairment in sexual functioning. These differences should be taken into account by physicians when choosing the best therapy for a patient.

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Quality of life in partners of patients with localised prostate cancer

December 2013

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40 Reads

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20 Citations

Quality of Life Research

The diagnosis of prostate cancer and the following treatment does not only affect the patient, but also his partner. Partners often suffer even more severely from psychological distress than the patients themselves. This analysis aims to describe the quality of life (QoL) after the cancer diagnosis over time and to identify the effects of possible predictors of partners' quality of life in a German study population. Patients with localised prostate cancer and their partners were recruited from a prospective multicenter study in Germany, the Prostate Cancer, Sexuality, and Partnership (ProCaSP) Study. At five observation times during the follow-up period of 2 years after diagnosis, QoL (EORTC QLQ-C30) and personal, social, and cancer-related health factors as well as adaptation and coping factors of 293 couples were observed and analysed with mixed effects analysis. The men's prostate cancer diagnosis had a small, but significant impact on their partner's QoL. However, QoL of partners was most affected by the partners' own physical health and psychological condition, time, and their relationship quality. The finding that average QoL increased again 3 months after diagnosis and later should give partners faith and hope for the future. The identified most important predictors of partners' QoL are potentially susceptible to intervention, and further research on target groups in special need of support and on adequate interventions is needed.


Decrease in Prostate Cancer Incidence and Mortality in Germany - Effects of Opportunistic PSA Screening or More?

September 2009

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24 Reads

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12 Citations

Urologia Internationalis

An increasing incidence and controversial interpretations about the valuation of improved survival rates are the main subjects of the discussion dealing with the epidemiology of the prostate carcinoma. In this study the most recent data of the Cancer Registry Schleswig-Holstein (the northernmost state of Germany) are introduced. Data from the population-based cancer registry covering a population of 2.8 million inhabitants were evaluated descriptively for the years 1999-2005. The frequency of more prognostic favourable diagnosis rose in the analyzed period. In 2000-2001, 62.9% of the patients were diagnosed with stage I/II and in 2004-2005 the percentage rose to 67.9%. From 1999 to 2003 the age-adjusted incidence increased by 30% and declined to the level of 1999 within 2 years. Mortality decreased continuously and from 1999 to 2005 it dropped by 20%. We assume that a selected group of men in Schleswig-Holstein has been screened regularly by PSA testing. The rise of incidence could be interpreted as a typical effect of a screening prevalence round. Thereafter the incidence declined because of the initial screening effect. However, it is not yet evident whether the PSA tests will have further effects on mortality rates.


Figure 1: Distribution of answers for the single items pain, energy, support, and communication (in %)
Figure 2: Distribution of answers for the single items emotional well-being, urinary frequency, urinary incontinence, and sexual function (in %)
Table 2 : Characteristics of the study samples (N; percentages in parentheses)
Figure 3: Distribution of answers for the single items sexual interest and bowel problems (in %)
Table 4 : Tumor stage at diagnosis of the study samples (N; percentages in parentheses)
Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P)

September 2009

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207 Reads

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15 Citations

BMC Cancer

The PORPUS-P is a short questionnaire for measuring prostate-specific quality of life (QoL), which was designed in Canada for use in prostate cancer (PC) patients. We aimed to generate a German version and compare PORPUS-P scores of German reference men from the general population, and German and Canadian patients with newly diagnosed PC who were scheduled to receive radical prostatectomy (RP) or radiotherapy (RT). The study sample consisted of 988 reference men, 121 German and 66 Canadian PC patients scheduled for RT, and 371 German and 68 Canadian PC patients scheduled for RP. All men completed the PORPUS-P (German postal questionnaire, Canada personal interview). Data were gathered from PC patients before the start of therapy. Canadian patients were better educated than the German patients, and fewer were retired. Patients scheduled to receive RT were older and more were retired. German RT patients had lower D'Amico risk scores and pre-treatment Gleason scores than RP patients, and Canadian RT patients had higher pre-treatment PSA than RP patients. Urinary and sexual dysfunction were seen in PC patients (especially RT patients), but were also common in the German reference men. Crude mean PORPUS-P scores differed statistically significant between German RT and RP and Canadian RP and RT patients, with RT patients having higher QoL scores. The differences in age-adjusted mean PORPUS-P scores between reference men and RP patients were not clinically significant, while RT patients had (clinically) significantly lower scores than the reference men. The German translation of the PORPUS-P appears to be a short and feasible tool for assessing prostate-specific QoL. Although we found a similar response pattern, Canadian and German PC patients scheduled to receive RT or RP rated their pre-treatment quality of life on different levels, which reveals the need for national reference data. Problems in several QoL domains exist before treatment, and differ between PC patients scheduled for RT and RP.



The German HTA report: Orchiectomy versus LH-RH analogues in the treatment of advanced prostate carcinoma: Are there any consequences for the daily health service?

December 2008

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19 Reads

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5 Citations

Aktuelle Urologie

This systematic review evaluates international data on the medical effectiveness of orchiectomy and medical therapy with LH-RH analogues in patients with advanced prostate cancer. These results are discussed in the context of primary, neoadjuvant, adjuvant and intermittent hormone deprivation. A systematic, diversified literature analysis in the common medical and HTA databases and further media was conducted. All identified, randomised and controlled studies concerning the application of LH-RH analogues showed the same medical effectiveness for orchiectomy and for treatment with LH-RH analogues. Four different studies regarding the quality of life revealed no significant difference between the treatment with LH-RH analogues and the therapy with orchiectomy. According to available studies, there is clear evidence for the equivalent effectiveness of LH-RH analogues and orchiectomy in the treatment of advanced prostate cancer. A change back to orchiectomy - even though it is more cost-efficient - cannot be recommended when taking the extended indications for temporary hormone deprivation into consideration.


Orchiectomy versus medical therapy with LH-RH analogues for the treatment of advanced prostatic carcinoma

May 2006

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64 Reads

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5 Citations

In Germany prostatic cancer is the most frequent cancer in men. The therapy of advanced prostatic cancer has changed significantly from the sub capsulate and / or total orchiectomy to the medical LH-RH analogues therapy during the last ten years, which has considerable effects on results and on costs. Both treatment procedures are based on a slowing down regulation of the growth of the hormone sensitive, neoplastic prostatic cells by the withdrawal of testosterone, which is clinically accompanied by a slowed tumor progression. This health technology assessment depicts and evaluates international data of medical effectiveness and efficiency of orchiectomy and medical therapy with LH-RH-analogues in patients with advanced prostate cancer. A systematic, diversified literature analysis in the common medical, economic and HTA data bases and further media was conducted. Five identified, randomized and controlled studies concerning the application of LH-RH analogues showed the same medical effectiveness of orchiectomy and treatment with LH-RH analogues. Four different studies regarding the quality of life revealed no significant difference between the treatment with LH-RH analogues and the therapy with orchiectomy. Dealing with health economic aspects seven cost-minimizing studies and one cost effectiveness study could be identified. All cost-minimizing studies show methodological restrictions. In general all studies draw the conclusion that the treatment of advanced prostatic cancer with orchiectomy is the most cost effective method, if one assumes a remaining life expectancy of more than one year. According to available studies, there is clear evidence for the equivalent effectiveness of LH-RH analogues and orchiectomy. Until now the studies - due to immense methodological restrictions - could not supply sufficient scientific evidence concerning the aspects of quality of life. In cases of a remaining life expectancy of more than one year, the orchiectomy is the more cost-effective alternative of therapy.



Validation of the German prostate-specific module

March 2006

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31 Reads

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18 Citations

World Journal of Urology

Theoretically, all patients newly diagnosed with prostate cancer are faced with a choice of treatment options: radical prostatectomy or radio therapy. Although these different treatments may have no differences in terms of survival, they may have very different consequences on the subsequent quality of life (QoL). Prerequisite to analyze QoL is a reliable and valid instrument to assess these differences not only in terms of general QoL (EORTC QLQ-C30) but prostate specific symptoms with a prostate specific module as well. Therefore, the aim of this study was a psychometric evaluation (validation) of the prostate-specific module (PSM). Five historical cohort studies were put together for an empirical meta-analysis. The main objective was to analyze the module's psychometric properties. The total sample consisted of 1,185 patients, of whom 950 completed the QoL questionnaires (EORTC QLQ-C30 and a prostate specific module developed by Kuechler et al.). First step of analysis was a principal component analysis that revealed the following scales: urinary problems, incontinence, erectile dysfunction, sexual problems, problems with partner, pain, heat, nutrition, and psychic strain. The module showed good reliability and concurrent validity and very good construct validity, since the module is able to discriminate between different treatment regimes, tumor stages and age. The German PSM is a reliable, valid and applicable tool for QoL in patients with prostate cancer.


Prescription Practice for LH-RH Analogs and Androgen Receptor Antagonists in the Treatment of Advanced Prostate Cancer in Germany (1993–2003)

February 2006

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21 Reads

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3 Citations

Urologia Internationalis

Nearly 80% of the patients suffering from advanced stages of prostate cancer in Germany are treated currently with luteinizing hormone-releasing hormone (LH-RH) analogs alone or in combination with androgen receptor antagonists. The aim of this study was to assess whether the prescription practice for LH-RH analogs and direct antiandrogens between 1993 and 2003 parallels the rise in the incidence rates for prostate cancer associated with the proportional rise in daily doses. Between 1993 and 2000 a yearly randomly selected number of receipts has been evaluated from official pharmacies in Germany which have been billed to public health insurance companies. Data concerning drug use, number of daily doses, and total cost of the respective drugs have been calculated by the Research Institute of the AOK (Wissenschaftliches Institut der AOK, WIdO). These prescription data have been related to incidence and mortality rates of patients with prostate cancer. Between 1993 and 2003 the age-standardized incidence rate of carcinomas of the prostate has risen by 180%, while the disease-specific mortality practically has remained nearly at the same level. The daily prescribed doses of LH-RH analogs have risen by a factor of 8.5 from 3.9 to 33.5 million daily doses during this time. In contrast, the daily doses of androgen receptor antagonists have remained unchanged between 1997 and 2001, followed by a rise of 50% between 2001 and 2003. The first analysis of the prescription practice of antiandrogens in the treatment of prostate cancer with respect to the incidence rates in Germany could only be facilitated by the fact that these medications are in exclusive use for this indication in Germany. The rise in prescriptions may be explained by the therapy shift from surgery to LH-RH application until the year 2000; the reasons for a further rise since 2000 remain speculative. In conclusion, only prevalence data would allow the exact calculation of medication needs among prostate cancer patients.


Citations (29)


... These deletions were not related to the stage or grade of the tumor (Dahiya et al., 1997). Amplification of chromosome 3q25-27 in primary prostate cancer was identified by CGH (comparative genomic hybridisation), Southern blot and comparative PCR (polymerase chain reaction) (Sattler et al., 2000). ...

Reference:

Identification of a high frequency of chromosomal rearrangements in the centromeric regions of prostate cancer patients
Novel amplification unit at chromosome 3q25–q27 in human prostate cancer
  • Citing Article
  • November 2000

The Prostate

... Erstaunlicherweise lag in meiner Studie, ähnlich wie bei Sattler und Mitarbeitern, der minimal überlappende Bereich auf 8q21.1-21.3 (Sattler et al., 1999). Cher und ...

Comparative genomic hybridization reveals DNA copy number gains to frequently occur in human prostate cancer
  • Citing Article
  • May 1999

The Prostate

... It is common for patients to experience urinary incontinence (UI) after radical prostatectomy [4,5]. With the rapid development of minimally invasive techniques and instruments, robotic-assisted laparoscopic radical prostatectomy (RARP) is superior to open surgery in reducing postoperative complications, and gradually replacing open radical prostatectomy as a recommended treatment option among male patients with clinically localized prostate cancer [6]. ...

The ProCaSP study: Quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study Urological oncology

BMC Urology

... 13 Multiple stenoses of the collecting system from the infundibulum to the ureterovesical junction are the findings most suggestive of urogenital tuberculosis, occurring in 60% to 84% of cases. 65,72,74 In patients with a contracted bladder due to tuberculosis, the most frequent and characteristic radiologic finding is unilateral nonfunctioning kidney, contracted bladder, and vesicoureteral reflux into the functional contralateral kidney (Figure 3). 75 Epididymal tuberculosis presents as a hypoechoic lesion involving the whole epididymis or just its head, with heterogeneous texture and concomitant testicular involvement in 38.9% of cases. ...

Surgical management of urinary tuberculosis: A review of 341 patients
  • Citing Article
  • April 1999

The Journal of Urology

... Literatürde kanser tanısı konan kadınların uyum süreçleri ile ilgili araştırmalar çoğunlukta olup, eşlerin hastalığa ve tedavi süreçlerine nasıl tepkiler verdikleri ve nasıl uyum sağladıklarını inceleyen çalışmalar son yıllarda artış göstermeye başlanmıştır (13,20,31) . Okanlı ve Ekinci (32) , meme kanserli hasta ve eşlerini mastektomi öncesi ve sonrası karşılaştırdığı araştırmada, ameliyatın hasta ve eşlerin duygu kontrol düzeyleri üzerinde etkili olduğunu ve hem hastaların hem de eşlerinin duygularını ifade etmekten kaçındıklarını göstermişlerdir. ...

Quality of life in partners of patients with localised prostate cancer
  • Citing Article
  • December 2013

Quality of Life Research

... From an economic perspective, it is obvious that orchiectomy is much more advantageous than medical ADT. 12 When the answers of participants on this subject were examined, there was a high level of awareness in our research. Considering the studies comparing the side effects of medical ADT and surgical ADT, surgical ADT seems to be safer in terms of cardiovascular health, metabolic parameters, and bone health. ...

Orchiectomy versus medical therapy with LH-RH analogues for the treatment of advanced prostatic carcinoma

... Previous studies on opportunistic diagnostic activity for prostate cancer have mainly compared incidence before and after the introduction of PSA testing and have shown large increases in the incidence of prostate cancer, predominately localized disease representing a substantial overdiagnosis. [2][3][4][5][6] The aim of this study was to quantify the outcomes associated with increasing diagnostic activity during the past couple decades since PSA testing began, comparing it with a hypothetical scenario with more restrictive diagnostic activity to see whether the increased diagnostic activity was associated with more treatment and decreased mortality by use of a new model that simulates incidence, treatment trajectories, and mortality when given a specific scenario of diagnostic activity. 7 ...

Decrease in Prostate Cancer Incidence and Mortality in Germany - Effects of Opportunistic PSA Screening or More?
  • Citing Article
  • September 2009

Urologia Internationalis

... 8,11 Therefore, HRQOL is multidimensional and subjective, encompassing occupational and physical function, psychological state, social interaction, and somatic sensation. 11 Among patients with prostate cancer, HRQOL can influence activities of daily life, social life, and role function 12 and is an important factor in a patient's decision-making process. 13 For purposes of this article, we defined health-related quality of life as perceived physical and mental health and function over time. ...

Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P)

BMC Cancer

... В недавно проведенном анализе «Оценка технологий здравоохранения» (Health Technology Assessment), изучавшем эффективность орхиэктомии в сравнении с лечением агонистами ЛГРГ, были также проанализированы экономические данные. Несмотря на продемонстрированное исследованиями снижение затрат, которое достигается путем хирургической кастрации, авторы пришли к выводу, что орхиэктомия не может быть рекомендована с учетом расширенных показаний для временной гормональной депривации [53]. ...

The German HTA report: Orchiectomy versus LH-RH analogues in the treatment of advanced prostate carcinoma: Are there any consequences for the daily health service?
  • Citing Article
  • December 2008

Aktuelle Urologie