Astellas Pharma a/s - Nordic Operations, Kastrup, Denmark.
Department of Oncology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Scand J Urol. 2021 Feb;55(1):1-8. doi: 10.1080/21681805.2020.1851762. Epub 2020 Dec 10.
To investigate time spent in hormone-sensitive and castration-resistant disease states in men with advanced prostate cancer in Sweden, and the associated health economic impact.
Registry study (NCT03619980) of the Prostate Cancer data Base Sweden with data from the National Prostate Cancer Register, including the Patient-overview Prostate Cancer (PPC) and other national healthcare registries. The primary endpoint was time in each disease state. Secondary endpoints were co-medications, comorbidities and healthcare resource utilization (HRU) and cost in each disease state.
In total, 1,869 men with advanced prostate cancer registered in PPC between 2014 and 2016, with data on the start of androgen deprivation therapy, were identified. Median time to progression and median survival were 4 and 11 years, respectively, for men with non-metastatic (nm) hormone-sensitive prostate cancer (HSPC); 1 and 7 years for men with metastatic (m) HSPC; and 1 and 8.5 years for men with nm castration-resistant prostate cancer (CRPC). Median survival for men with mCRPC was 4 years. Total annual mean costs for HRU per patient increased with increasing severity of disease, from 41,064 Swedish krona (SEK) for nmHSPC to 288,242 SEK for mCRPC.
Progression time from mHSPC and nmCRPC to the mCRPC state was short and survival in the mCRPC state was approximately 4 years. Survival times were longer than expected, likely due to the selection of long-term survivors among prevalent cases. Healthcare costs were high for men with mCRPC. Further studies are needed to confirm our pilot study findings.
研究瑞典晚期前列腺癌男性患者处于激素敏感性和去势抵抗性疾病状态的时间，以及相关的健康经济学影响。
对前列腺癌数据库瑞典的一项注册研究（NCT03619980），数据来自国家前列腺癌登记处，包括患者概述前列腺癌（PPC）和其他国家卫生保健登记处。主要终点是每种疾病状态的时间。次要终点是每种疾病状态的共同药物治疗、合并症和医疗资源利用（HRU）和成本。
总共在 2014 年至 2016 年期间在 PPC 中登记了 1869 名患有晚期前列腺癌的男性，其中有关于开始雄激素剥夺治疗的数据。非转移性（nm）激素敏感性前列腺癌（HSPC）男性进展和中位生存时间分别为 4 年和 11 年；转移性（m）HSPC 男性为 1 年和 7 年；nm 去势抵抗性前列腺癌（CRPC）男性为 1 年和 8.5 年。mCRPC 男性的中位总生存时间为 4 年。随着疾病严重程度的增加，每位患者的 HRU 年平均总成本增加，从 nmHSPC 的 41064 瑞典克朗（SEK）增加到 mCRPC 的 288242 SEK。
从 mHSPC 和 nmCRPC 进展为 mCRPC 状态的时间很短，mCRPC 状态的生存时间约为 4 年。生存时间比预期的要长，可能是由于在现患病例中选择了长期生存者。mCRPC 男性的医疗保健费用很高。需要进一步研究来证实我们的初步研究结果。
