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Minerva Urologica e Nefrologica 2020 Nov 17

DOI: 10.23736/S0393-2249.20.03925-9


language: English

The waiting time for prostate cancer treatment in Italy: analysis from the Pros-IT CNR study

Mauro GACCI 1 , Isabella GRECO 1, Walter ARTIBANI 2, Pierfrancesco BASSI 3, Filippo BERTONI 4, Sergio BRACARDA 5, Alberto BRIGANTI 6, Giorgio CARMIGNANI 7, Luca CARMIGNANI 8, Giario CONTI 9, Renzo CORVÒ 10, Cosimo DE NUNZIO 11, Ferdinando FUSCO 12, Pierpaolo GRAZIOTTI 13, Stefania MAGGI 14, Stefano M. MAGRINI 15, Vincenzo MIRONE 12, Rodolfo MONTIRONI 16, Giovanni MUTO 17, Marianna NOALE 14, Stefano PECORARO 18, Angelo PORRECA 19, Umberto RICARDI 20, Elvio RUSSI 21, Andrea SALONIA 22, Alchiede SIMONATO 23, Sergio SERNI 1, Andrea TUBARO 11, Vittorina ZAGONEL 24, Gaetano CREPALDI 14, the Pros-IT CNR Study Group

1 Department of Urology, University of Florence, Florence, Italy; 2 Urologic Clinic, Department of Oncological and Surgical Sciences, AOU Integrata and University of Verona, Verona, Italy; 3 Department of Urology, University of Rome La Cattolica, Rome, Italy; 4 AIRO - Italian Association for Radiation Oncology; 5 Department of Oncology, Santa Maria Hospital, Terni, Italy; 6 Department of Urology, Vita-Salute San Raffaele University, Milan, Italy; 7 Department of Urology, University of Genoa, Genoa, Italy; 8 Department of Urology, San Donato Policlinic Hospital, Milan, Italy; 9 Department of Urology, St. Anna Hospital, Como, Italy; 10 Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino - and University, Genoa, Italy; 11 Department of Urology, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy; 12 Department of Urology, University Federico II, Naples, Italy; 13 Department of Urology, San Giuseppe Hospital, Milan, Italy; 14 National Research Council (CNR), Neuroscience Institute, Aging Branch, Padua, Italy; 15 Radiation Oncology Unit, University of Brescia and Spedali Civili Hospital, Brescia, Italy; 16 Section of Pathological Anatomy, Polytechnic University of the Marche Region, Ancona, Italy; 17 Department of Urology, Humanitas, Hospital Gradenigo, Torino, Italy; 18 Department of Nephrourology, Malzoni Center, Avellino, Italy; 19 Department of Urology, Abano Terme General Hospital, Padua, Italy; 20 Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy; 21 Radiation Unit, San Croce e Carle Hospital, Cuneo, Italy; 22 Division of Experimental Oncology/Unit of Urology, URI, IRCCS San Raffaele Hospital, Milan, Italy; 23 Department of Surgical, Oncological and Stomatological Sciences, Section of Urology, University of Palermo, Palermo, Italy; 2 4Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy


BACKGROUND: Prostate cancer (PCa) is the second most common neoplasm in male patients. To date, there’s no certain indication about the maximum waiting time (WT) acceptable for treatment beginning and the impact on oncological and functional outcomes has not been well established.
METHODS: Data from the National Research Council PCa monitoring multicenter project in Italy (Pros-IT CNR) were prospectively collected and analyzed. WT was defined as the time from the bioptical diagnosis of PCa to the first treatment received. Patients were divided in two groups, using a time frame of 90 days. Quality of life was measured through the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and of the Short-Form Health Survey (SF-12). The occurrence of upgrading, upstaging, presence of lymph node metastasis and positive surgical margins at the final histopathological diagnosis, and PSA at 12 months follow-up were evaluated.
RESULTS: The overall median WT was 93 days. The logistic multivariable model confirmed that age, being resident in Southern regions of Italy and T staging at diagnosis were significantly associated with a WT >90 days. At 6 months from diagnosis the mean SF-12 score for the emotionalpsychological component was significantly lower in WT ≥ 90 days group (p=0.0428). Among patients treated with surgical approach, no significant differences in oncological outcomes were found in the two groups.
CONCLUSIONS: In our study age, clinical T stage and provenance from Southern regions of Italy are associated with a WT > 90 days. WT might have no impact on functional and oncological outcome.

KEY WORDS: Waiting time; Prostate cancer; Radical prostatectomy; Radiotherapy; Androgen deprivation therapy

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