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Wie es Eltern und ihren Kindern während der Corona-Pandemie geht, wie ihr aktuelles Wohlbefinden ist, was ihren Alltag kennzeichnet, wie die Passung zu den Regelungen der Kitabetreuung, Schulöffnung und auch der Arbeitgeber*innen ist – dies sind die Kernfragen der Onlinebefragung KiCo, welche im Zeitraum vom 24.04.2020 – 03.05.2020 durchgeführt wurde. Dieses Papier präsentiert erste Ergebnisse der Studie, an der über 25.000 Personen teilgenommen haben. Die Studie wurde umgesetzt vom Forschungsverbund "Kindheit – Jugend – Familie in der Corona-Zeit", der sich aus den Universitäten Hildesheim, Frankfurt und Bielefeld zusammensetzt.
Dieses Papier präsentiert erste Ergebnisse der bundesweiten Studie JuCo – Erfahrungen und Perspektiven von jungen Menschen während der Corona-Maßnahmen. Die Befragung wurde vom Forschungsverbund "Kindheit – Jugend – Familie in der Corona-Zeit" umgesetzt, der sich aus den Universitäten Hildesheim, Frankfurt und Bielefeld zusammensetzt. Über 5.000 Jugendliche und junge Erwachsene zwischen 15 und 30 Jahren sind in die Analysen eingeflossen und zeigen auf, wie es den jungen Menschen geht und welche Botschaften sie haben.
Background: To evaluate the impact of time to castration resistance (TTCR) in metastatic hormone-sensitive prostate cancer (mHSPC) patients on overall survival (OS) in the era of combination therapies for mHSPC.
Material and Methods: Of 213 mHSPC patients diagnosed between 01/2013-12/2020 who subsequently developed metastatic castration resistant prostate cancer (mCRPC), 204 eligible patients were analyzed after having applied exclusion criteria. mHSPC patients were classified into TTCR <12, 12-18, 18-24, and >24 months and analyzed regarding OS. Moreover, further OS analyses were performed after having developed mCRPC status according to TTCR. Logistic regression models predicted the value of TTCR on OS.
Results: Median follow-up was 34 months. Among 204 mHSPC patients, 41.2% harbored TTCR <12 months, 18.1% for 12-18 months, 15.2% for 18-24 months, and 25.5% for >24 months. Median age was 67 years and median PSA at prostate cancer diagnosis was 61 ng/ml. No differences in patient characteristics were observed (all p>0.05). According to OS, TTCR <12 months patients had the worst OS, followed by TTCR 12-18 months, 18-24 months, and >24 months, in that order (p<0.001). After multivariable adjustment, a 4.07-, 3.31-, and 6.40-fold higher mortality was observed for TTCR 18-24 months, 12-18 months, and <12 months patients, relative to TTCR >24 months (all p<0.05). Conversely, OS after development of mCRPC was not influenced by TTCR stratification (all p>0.05).
Conclusion: Patients with TTCR <12 months are at the highest OS disadvantage in mHSPC. This OS disadvantage persisted even after multivariable adjustment. Interestingly, TTCR stratified analyses did not influence OS in mCRPC patients.
Probably, patients with de novo (synchronous) and recurrent (metachronous) oligometastatic hormone-sensitive prostate cancer have different oncologic outcomes. Thus, we are challenged with different scenarios in clinical practice, where different treatment options may apply. In the last years, several prospective studies have focused on the treatment of patients with de novo oligometastatic hormone-sensitive prostate cancer. Not only the addition of systemic therapeutic treatments, such as chemotherapy with docetaxel, abiraterone, enzalutamide, and apalutamide, next to androgen deprivation therapy, demonstrated to improve outcomes in these patients but also local therapy of the primary has been demonstrated to improve outcomes of low-volume metastatic disease. Next to radiotherapy, also radical prostatectomy has been reported as a feasible and safe treatment option. Additional metastasis-directed therapy in de novo metastatic disease is currently examined by four trials. In the recurrent metastatic setting, less data are available, and it remains uncertain if patients can be treated in the same way as synchronous oligometastatic disease. Metastasis-directed therapy has demonstrated to prolong outcomes, while data on survival are still missing.