RESUMO
OBJECTIVE: To study survival of patients with prostate cancer and its relationship with diagnostic delay. DESIGN: Retrospective cohort study. SETTING: Six rural primary care practices. PARTICIPANTS: All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. MAIN MEASUREMENTS: Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. RESULTS: A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. CONCLUSIONS: Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer.
Assuntos
Neoplasias da Próstata/mortalidade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Objetivo. Analizar la supervivencia de los pacientes afectados de cáncer de próstata y su relación con la demora diagnóstica. Diseño. Estudio de cohortes retrospectivo. Emplazamiento. Seis consultas rurales de atención primaria. Participantes. La totalidad de pacientes diagnosticados de cáncer de próstata entre 1992 y 2005 atendidos en dichas consultas. Mediciones principales. Se determinaron la edad en el momento del diagnóstico de confirmación, las fechas de diagnóstico de sospecha y confirmación, el método diagnóstico, la estrategia terapéutica y la fecha de fallecimiento cuando procedía. Se utilizó el método de Kaplan-Meier en la determinación de la probabilidad de supervivencia y el análisis de regresión de Cox en la investigación de los factores pronósticos. Resultados. Se estudiaron 84 casos. La edad media ± desviación estándar (DE) en el momento del diagnóstico fue de 75,8 ± 8,6 años. La mediana del retraso en la confirmación diagnóstica fue de 31 días. El diagnóstico se realizó mediante biopsia en 38 casos (45,2%). Se realizó tratamiento potencialmente curativo en 18 casos (21,4%) y recibieron tratamiento paliativo 66 pacientes (78,6%). La edad media de los fallecidos era de 82,6 ± 9,1 años. Entre los 49 fallecidos en el momento del cierre del estudio, 22 (44,9%) murieron por el cáncer de próstata. La mediana de la supervivencia fue de 72,1 ± 6,1 meses. La probabilidad de supervivencia global a los 10 años tras el diagnóstico fue del 33,3%, y la específica, del 57,5%. No se encontraron diferencias en la supervivencia en función del retraso en la confirmación diagnóstica. Conclusiones. La supervivencia tras el diagnóstico de cáncer de próstata se puede considerar alta. No hay relación entre la supervivencia y el retraso en la confirmación del diagnóstico en el conjunto de los pacientes afectados de cáncer de próstata
Objective. To study survival of patients with prostate cancer and its relationship with diagnostic delay. Design. Retrospective cohort study. Setting. Six rural primary care practices. Participants. All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. Main measurements. Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. Results. A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. Conclusions. Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer
Assuntos
Masculino , Pessoa de Meia-Idade , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Análise de Regressão , Biópsia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Estudos de Coortes , Estudos Retrospectivos , Modelos Lineares , Modelos LogísticosRESUMO
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