title: [The HAROW study: an example of outcomes research: a prospective, non-interventional study comparing treatment options in localized prostate cancer].
abstract: BACKGROUND
  The HAROW study was initiated to investigate the provision of ongoing medical care for patients with localized prostate cancer in a prospective, noninterventional setting and to investigate treatment options (Hormonal treatment, Active surveillance, Radiotherapy, Operation, Watchful waiting) under real-life conditions.
  
  
  METHODS
  A total of 3169 patients were enrolled by 259 participating physicians in private practice in Germany. The median follow-up was 28.4 months. At 6-month intervals, the treating physicians reported data on clinical parameters, clinical course of disease, and quality of patient-physician interaction.
  
  
  RESULTS
  The highest proportion of patients with low risk tumor was found in the defensive treatment groups (AS and WW). As expected, the AS group showed the highest progression rate. In all, 112 AS patients (23.9%) changed therapeutic strategy, 21 of them upon medical advice in the absence of any signs of progression. Metastases were seen most frequently in the WW group (1.5%). No metastases occurred in AS patients. Medical support in managing the disease reached high scores in all groups, the highest in AS.
  
  
  CONCLUSIONS
  The data enable a differentiated comparative analysis of patient and tumor characteristics of each treatment group. Indication of AS was predominantly consistent with the guideline. The high rate of AS termination based on the physician's recommendation rather than on clinical progression is remarkable, and may be interpreted as a kind of insecurity in dealing with AS. Results regarding communication indicate that patients appreciated being involved in treatment decisions.
authors.affiliation: Klinik und Poliklinik für Urologie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland, jan.herden@uk-koeln.de.
authors.forename: J
authors.initials: J
authors.lastname: Herden
authors.forename: N
authors.initials: N
authors.lastname: Ernstmann
authors.forename: D
authors.initials: D
authors.lastname: Schnell
authors.forename: L
authors.initials: L
authors.lastname: Weißbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D014572:Urology / Q000592:standards*