Spandonaro Federico, D'Angela Daniela, Polistena Barbara, Bruzzi Paolo, Iacovelli Roberto, Luccarini Irene, Stagni Paola, Brigido Alessia
Department of Economic and Finance, C.R.E.A. Sanità (Consortium for Applied Economic Research in Healthcare), University of Rome Tor Vergata, 00196 Rome, Italy.
Unit of Clinical Epidemiology, Ospedale Policlinico San Martino-IRCCS, 16132 Genoa, Italy.
Biology (Basel). 2021 Mar 10;10(3):210. doi: 10.3390/biology10030210.
Understanding the distribution of prostate cancer (PC) at various clinical stages of disease is of utmost importance to quantify the cancer care needs of patients and to adequately plan health services. The aim of this analysis is thus to provide a model-based estimation of the number of prevalent PC patients at different clinical stages in the Italian setting. A simulation model of patient transitions was constructed on a yearly basis using data obtained through a literature review on the incidence, prevalence, progression and mortality of PC, with specific focus on disease stage. A total of 462,570 prevalent PC patients were estimated at 1 January 2019. According to the model, 94.8% of them had non-metastatic PC and 5.2% had metastatic disease. Among the non-metastatic patients, most had T1/T2 PC (85.6%), followed by T3/T4 (10.9%) and T0/Tx PC (3.6%). About 20% of the T3/T4 patients had biochemically recurrent PC. Among the metastatic PC patients, 66.1% had castration-resistant PC and 33.9% had hormone-sensitive PC. This study provided original information on the distribution of PC according to different clinical stages that may be useful to define strategies, understand the PC disease pathway, estimate treatment-related needs and, possibly, plan targeted interventions for public health management of prostate cancer in Italy.
了解前列腺癌（PC）在疾病不同临床阶段的分布情况对于量化患者的癌症护理需求以及合理规划医疗服务至关重要。因此，本分析的目的是基于模型估计意大利不同临床阶段的前列腺癌现患患者数量。每年利用通过对前列腺癌的发病率、患病率、进展和死亡率进行文献回顾获得的数据构建患者转移模拟模型，特别关注疾病阶段。估计在2019年1月1日共有462,570例前列腺癌现患患者。根据该模型，其中94.8%为非转移性前列腺癌患者，5.2%为转移性疾病患者。在非转移性患者中，大多数为T1/T2期前列腺癌（85.6%），其次是T3/T4期（10.9%）和T0/Tx期前列腺癌（3.6%）。约20%的T3/T4期患者存在生化复发的前列腺癌。在转移性前列腺癌患者中，66.1%为去势抵抗性前列腺癌，33.9%为激素敏感性前列腺癌。本研究提供了关于前列腺癌根据不同临床阶段分布的原始信息，这可能有助于确定策略、了解前列腺癌疾病路径、估计治疗相关需求，并有可能为意大利前列腺癌的公共卫生管理规划有针对性的干预措施。
