[Current Data from the National Registry for Prostate Cancer (ProNAT) by d-uo].

This publication reports initial results from the German National Prostate Cancer Registry (ProNAT), a prospective, non-interventional, multicenter registry designed to capture real-world prostate cancer management across outpatient and inpatient sectors.

Study design and population

• Prospective registry including patients with histologically confirmed prostate cancer from 55 urology centers.
• Enrollment: As of August 2025, 3,417 patients enrolled; 3,052 were analyzable.
• Median age: 69 years; 91.1% had ECOG performance status 0–1.
• Frequent comorbidities: arterial hypertension (30.6%), cardiovascular disease (9.1%), and diabetes mellitus (8.2%).

Disease characteristics and diagnostics

• Disease stage at diagnosis: 6.7% had metastatic disease; 77.6% had localized T1–T2 tumors.
• Imaging: Multiparametric MRI prior to biopsy was performed in 36.6% of patients, reflecting partial but incomplete adherence to guideline-recommended imaging practices.

Treatment patterns

• Curative surgery: predominantly performed robotically (87.7% of surgical cases).
• Low-risk disease (Gleason 3 + 3): 35.1% managed with active surveillance and 37.8% underwent surgery, indicating a substantial proportion still receiving definitive local therapy despite low-risk features.

Supportive care and quality-of-care indicators

• Psycho-oncological support: documented in only 18.2% of patients, suggesting underutilization of supportive services.
• Registry structure: designed to evaluate guideline adherence, quality of care, and treatment sequencing over time, though more mature longitudinal data are pending.

Implications

• Real-world overview: provides the first broad picture of prostate cancer care in German urology practices.
• Guideline adherence: early data suggest improving uptake of guideline-aligned diagnostics but highlight gaps in supportive care provision and multidisciplinary management.
• Future analyses: ongoing accrual will enable more granular evaluation of treatment pathways, outcomes, and quality indicators across the disease continuum.