Follow-up care over 12 months of patients with prostate cancer in Spain A multicenter prospective cohort study
Por:
Bonfill, X, Martinez-Zapata, MJ, Vernooij, RW, Sanchez, MJ, Morales-Suarez-Varela, M, Emparanza, JI, Ferrer, M, Pijoan, JI, Palou, J, Madrid, E, Abraira, V, Zamora, J
Publicada:
24 nov 2021
Resumen:
The therapeutic approach is crucial to prostate cancer prognosis. We describe treatments and outcomes for a Spanish cohort of patients with prostate cancer during the first 12 months after diagnosis and identify the factors that influenced the treatment they received. This multicenter prospective cohort study included patients with prostate cancer followed up for 12 months after diagnosis. Treatment was stratified by factors such as hospital, age group (<70 and >= 70 years), and D'Amico cancer risk classification. The outcomes were Eastern Cooperative Oncology Group (ECOG) performance status, adverse events (AEs), and mortality. The patient characteristics associated with the different treatment modalities were analyzed using multivariate logistic regression. We included 470 men from 7 Spanish tertiary hospitals (mean (standard deviation) age 67.8 (7.6) years), 373 (79.4%) of which received treatment (alone or in combination) as follows: surgery (n = 163; 34.7%); radiotherapy (RT) (n = 149; 31.7%); and hormone therapy (HT) (n = 142; 30.2%). The remaining patients (n = 97) were allocated to no treatment, that is, watchful waiting (14.0%) or active surveillance (5.7%). HT was the most frequently administered treatment during follow-up and RT plus HT was the most common therapeutic combination. Surgery was more frequent in patients aged <70, with lower histologic tumor grades, Gleason scores <7, and lower prostate-specific antigen levels; while RT was more frequent in patients aged >= 70 with histologic tumor grade 4, and higher ECOG scores. HT was more frequent in patients aged >= 70, with histologic tumor grades 3 to 4, Gleason score >= 8, ECOG >= 1, and higher prostate-specific antigen levels. The number of fully active patients (ECOG score 0) decreased significantly during follow-up, from 75.3% at diagnosis to 65.1% at 12 months (P < .001); 230 (48.9%) patients had at least 1 AE, and 12 (2.6%) patients died. Surgery or RT were the main curative options. A fifth of the patients received no treatment. Palliative HT was more frequently administered to older patients with higher tumor grades and higher Gleason scores. Close to half of the patients experienced an AE related to their treatment.
Filiaciones:
Bonfill, X:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Inst Biomed Res St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Hosp Santa & Creu St Pau, Publ Hlth & Clin Epidemiol Serv, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Martinez-Zapata, MJ:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Inst Biomed Res St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Univ Tecnol Equinoccial, Fac Ciencias Salud Eugenio Espejo, CISPEC, Cochrane Ecuador, Quito, Ecuador
Vernooij, RW:
Inst Biomed Res St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Sanchez, MJ:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Inst Invest Biosanitaria Granada, Escuela Andaluza Salud Publ, Barcelona, Spain
Morales-Suarez-Varela, M:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Univ Valencia, Dept Prevent Med, Unit Publ Hlth & Environm Care, Valencia, Spain
Emparanza, JI:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Hosp Univ Donostia, Clin Epidemiol Unit, BioDonostia, San Sebastian, Spain
Ferrer, M:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
IMIM Hosp dek Mar Med Res Inst, Hlth Serv Res Grp, Barcelona, Spain
Pijoan, JI:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Hosp Univ Cruces, Biocruces, Clin Epidemiol Unit, Baracaldo, Spain
Palou, J:
Fundacio Puigvert, Barcelona, Spain
Madrid, E:
Univ Valparaiso, Interdisciplinary Ctr Hlth Studies CIESAL, Sch Med, Cochrane Ctr,Dept Publ Hlth, Valparaiso, Chile
Abraira, V:
Hosp Univ Ramon y Cajal, Unidad Bioestadist Clin, IRYCIS, Madrid, Spain
Zamora, J:
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Hosp Univ Ramon y Cajal, Unidad Bioestadist Clin, IRYCIS, Madrid, Spain
Queen Mary Univ London, Barts & London Sch Med & Dent, London, England
gold, Green Published
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