Ticino Cancer Registry, Cantonal Institute of Pathology, Via in Selva 24, 6600, Locarno, Switzerland.
Clinical Pathology, Cantonal Institute of Pathology, 6600, Locarno, Switzerland.
BMC Cancer. 2018 Jul 11;18(1):733. doi: 10.1186/s12885-018-4604-2.
Quality of cancer care (QoCC) has become an important item for providers, regulators and purchasers of care worldwide. Aim of this study is to present the results of some evidence-based quality indicators (QI) for prostate cancer (PC) at the population-based level and to compare the outcomes with data available in the literature.
The study included all PC diagnosed on a three years period analysis (01.01.2011-31.12.2013) in the population of Canton Ticino (Southern Switzerland) extracted from the Ticino Cancer Registry database. 13 QI, approved through the validated Delphi methodology, were calculated using the "available case" approach: 2 for diagnosis, 4 for pathology, 6 for treatment and 1 for outcome. The selection of the computed QI was based on the availability of medical documentation. QI are presented as proportion (%) with the corresponding 95% confidence interval.
700 PC were detected during the three-year period 2011-2013: 78.3% of them were diagnosed through a prostatic biopsy and for 72.5% 8 or more biopsy cores were taken. 46.5% of the low risk PC patients underwent active surveillance, while 69.2% of high risk PC underwent a radical treatment (radical prostatectomy, radiotherapy or brachytherapy) and 73.5% of patients with metastatic PC were treated with hormonal therapy. The overall 30-day postoperative mortality was 0.5%.
Results emerging from this study on the QoCC for PC in Canton Ticino are encouraging: the choice of treatment modalities seems to respect the international guidelines and our results are comparable to the scarce number of available international studies. Additional national and international standardisation of the QI and further QI population-based studies are needed in order to get a real picture of the PC diagnostic-therapeutic process progress through the definition of thresholds of minimal standard of care.
癌症治疗质量（QoCC）已成为全球医疗服务提供者、监管者和购买者关注的重要内容。本研究旨在展示基于人群的前列腺癌（PC）一些循证质量指标（QI）的结果，并将结果与文献中的数据进行比较。
本研究纳入了 2011 年 1 月 1 日至 2013 年 12 月 31 日在提契诺癌症登记处数据库中提取的提契诺州（瑞士南部）人群中诊断为 PC 的所有病例。使用“可用病例”方法计算了通过经过验证的德尔菲法批准的 13 项 QI，其中包括 2 项诊断、4 项病理学、6 项治疗和 1 项预后：2 项诊断、4 项病理学、6 项治疗和 1 项预后。选择计算的 QI 基于医疗记录的可用性。QI 以比例（%）表示，相应的 95%置信区间。
2011-2013 年三年期间共检出 700 例 PC，其中 78.3%通过前列腺活检诊断，72.5%的患者活检取 8 个或更多活检芯。46.5%的低危 PC 患者接受主动监测，69.2%的高危 PC 患者接受根治性治疗（前列腺切除术、放疗或近距离放疗），73.5%的转移性 PC 患者接受激素治疗。总的 30 天术后死亡率为 0.5%。
本研究对提契诺州 PC 的 QoCC 结果令人鼓舞：治疗方式的选择似乎符合国际指南，我们的结果与为数不多的可用国际研究相当。需要进一步在全国和国际范围内对 QI 进行标准化，并开展更多基于人群的 QI 研究，以便通过定义最低标准护理的阈值来了解 PC 诊断-治疗过程的进展情况。
