Ribal Maria José, Martínez-Salamanca Juan Ignacio, García Freire Camilo
Department of Urology, Hospital Clínic, Carrer Villarroel 170, 08036 Barcelona, Spain.
Department of Urology, Hospital Universitario Puerta de Hierro, Calle Manuel de Falla, 1, Majadahonda, 28222 Madrid, Spain.
Prostate Cancer. 2015;2015:186740. doi: 10.1155/2015/186740. Epub 2015 Jul 13.
Objective. To describe urologists' practice patterns when managing patients with advanced prostate cancer (PCa) in Spain. Methods. This was an observational study conducted by 120 urologists using retrospective data of advanced PCa patients attending hospitals and outpatient centers. Results. Urologists evaluated a total of 375 patients (mean age: 75 years; ECOG 0-1: 77%; mean serum PSA levels at study entry: 50.5 ng/Ml). Approximately 50% of patients had bone metastases, and 60.6% experienced pain as the main symptom of progressive disease. Primary androgen deprivation therapy (ADT) use was 99.7%, with continuous ADT as the dominant strategy (91.9%). After failure of initial ADT, antiandrogen withdrawal was the next method most commonly used in 57% of patients. Choice of secondary hormonal treatment was made mostly by urologists (96%), who continued to monitor patients. Patient follow-up after chemotherapy and supportive care were mainly done in urology units, although responsibility was shared with medical oncologists and radiologists. Conclusion. The urologists' attitudes towards management of PCa in the routine practice in Spain show the urologist as an integral component even when patients progress to advanced stages of the disease.
目的。描述西班牙泌尿外科医生在管理晚期前列腺癌(PCa)患者时的实践模式。方法。这是一项由120名泌尿外科医生进行的观察性研究,使用了在医院和门诊中心就诊的晚期PCa患者的回顾性数据。结果。泌尿外科医生共评估了375例患者(平均年龄:75岁;东部肿瘤协作组体能状态0 - 1:77%;研究开始时平均血清前列腺特异抗原水平:50.5 ng/Ml)。约50%的患者有骨转移,60.6%的患者以疼痛作为疾病进展的主要症状。一线雄激素剥夺治疗(ADT)的使用率为99.7%,其中持续ADT为主要策略(91.9%)。初始ADT失败后,57%的患者最常采用的下一步治疗方法是抗雄激素撤药。二线激素治疗的选择大多由泌尿外科医生做出(96%),他们继续对患者进行监测。化疗和支持治疗后的患者随访主要在泌尿外科进行,不过肿瘤内科医生和放射科医生也分担部分责任。结论。在西班牙的日常实践中,泌尿外科医生对PCa管理的态度表明,即使患者进展到疾病晚期,泌尿外科医生仍是不可或缺的组成部分。