Costa Amanda Caroline de Souza, Korkes Fernando, Rinck Junior Jose Augusto, Cunha Frederico Timóteo Silva, Barros Luciana Holtz de Camargo, Zequi Stênio de Cássio, Formiga Maria Nirvana da Cruz
AC Camargo Cancer Center, São Paulo, SP, Brazil.
Centro Universitário FMABC, Santo André, SP, Brazil.
Einstein (Sao Paulo). 2025 May 2;23:eAO0851. doi: 10.31744/einstein_journal/2025AO0851. eCollection 2025.
To evaluate the impact of assistance from public and private health systems on the overall survival of patients with metastatic prostate cancer.
A total of 213 patients with metastatic prostate cancer treated at the A.C. Camargo Cancer Center, either in the Unified Health System or a private system, from January 2014 to December 2018 were analyzed. Multivariate analysis of overall survival was performed to adjust for the type of health assistance and other clinical prognostic factors.
Of 213 included patients, 147 (69%) were from the private system and 66 (31%) were from the Unified Health System. There was a significant difference in the median age at diagnosis between the systems (63.4 years for patients in the private system versus 67.2 years for patients in the Unified Health System, p=0.027). No significant differences in performance status were observed between the groups (p=0.695). Patients treated in the public system had access to fewer treatment lines (2.59 lines in the public system versus 3.04 lines in the private system, p=0.024). Our data revealed a longer median survival for patients with private health care (115 months for patients with private health care versus 78 months for patients in the Unified Health System, p=0.009). Multivariate analysis revealed that patients in the public system had a 66% higher risk of death than those in the private system.
Our data demonstrate that patients in the Unified Health System have access to fewer lines of therapy for metastatic prostate cancer, resulting in shorter median survival than patients treated in the private system.
评估公立和私立医疗系统的援助对转移性前列腺癌患者总生存期的影响。
分析了2014年1月至2018年12月期间在A.C. 卡马戈癌症中心接受治疗的213例转移性前列腺癌患者，这些患者分别来自统一医疗系统或私立医疗系统。对总生存期进行多变量分析，以调整医疗援助类型和其他临床预后因素。
在纳入的213例患者中，147例（69%）来自私立医疗系统，66例（31%）来自统一医疗系统。两个系统之间诊断时的中位年龄存在显著差异（私立医疗系统患者为63.4岁，统一医疗系统患者为67.2岁，p = 0.027）。两组之间在体能状态方面未观察到显著差异（p = 0.695）。在公立医疗系统接受治疗的患者可获得的治疗线较少（公立医疗系统为2.59条治疗线，私立医疗系统为3.04条治疗线，p = 0.024）。我们的数据显示，接受私立医疗的患者中位生存期更长（接受私立医疗的患者为115个月，统一医疗系统的患者为78个月，p = 0.009）。多变量分析显示，公立医疗系统的患者死亡风险比私立医疗系统的患者高66%。
我们的数据表明，统一医疗系统的转移性前列腺癌患者可获得的治疗线较少，导致中位生存期比私立医疗系统治疗的患者短。
