Department of Urology, University of Florence, Florence, Italy -
Department of Urology, University of Florence, Florence, Italy.
Minerva Urol Nephrol. 2022 Feb;74(1):38-48. doi: 10.23736/S2724-6051.20.03925-9. Epub 2020 Nov 17.
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.
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.
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 emotional-psychological 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.
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.
前列腺癌（PCa）是男性患者中第二常见的肿瘤。迄今为止，尚无关于可接受的治疗开始的最长等待时间（WT）的明确指示，并且其对肿瘤学和功能结果的影响尚未得到很好的确定。
前瞻性地收集并分析了来自意大利国家研究委员会前列腺癌监测多中心项目（Pros-IT CNR）的数据。WT 定义为从前列腺癌的生物诊断到首次接受治疗的时间。患者分为两组，使用 90 天的时间框架。使用加利福尼亚大学洛杉矶分校前列腺癌指数（UCLA-PCI）和健康调查简表（SF-12）的意大利语版本来衡量生活质量。评估最终组织病理学诊断中的升级、分期、淋巴结转移和阳性手术切缘的发生以及 12 个月随访时的 PSA。
总体中位 WT 为 93 天。逻辑多变量模型证实，年龄、居住在意大利南部地区和诊断时的 T 分期与 WT>90 天显著相关。在诊断后 6 个月，WT≥90 天组的 SF-12 评分在情绪心理成分方面明显较低（P=0.0428）。在接受手术治疗的患者中，两组之间在肿瘤学结果方面没有发现显著差异。
在我们的研究中，年龄、临床 T 分期和来自意大利南部地区的来源与 WT>90 天有关。WT 可能对功能和肿瘤学结果没有影响。
