Determinants of Survival and Prognostic Factors in Patients with Prostate Cancer: A Retrospective Analysis (2009-2018)
Carla Simone Moreira de Freitas *
Hospital do Câncer de Muriaé-MG – Fundação Cristiano Varella, Muriaé, Minas Gerais, Brasil, Brazil.
Amanda Damasceno de Souza
Programa de Pós-Graduação em Tecnologia da Informação e Comunicação e Gestão do Conhecimento (PPGTICGC) - Universidade FUMEC, Brazil.
Fabiana Rocha-Silva
Faculdade Santa Casa de Belo Horizonte, Minas Gerais, Brasil, Brazil.
Thaís Almeida Marques-Silva
Faculdade Santa Casa de Belo Horizonte, Minas Gerais, Brasil, Brazil.
Aleida Nazareth Soares
Faculdade Santa Casa de Belo Horizonte, Minas Gerais, Brasil, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Objective: To evaluate prognostic factors and survival determinants of patients with prostate cancer (PC) admitted to an oncology hospital.
Methods: Retrospective cohort study on 3,450 medical records of patients undergoing cancer treatment from 2009 to 2018, with follow-up until 2020, at the Center for High Complexity in Oncology (CACON), Muriaé, Minas Gerais, Brazil. Overall survival was estimated using the Kaplan-Meier method. For paired comparisons, the log-rank test was used. For multivariate analysis, the Cox Proportional Hazards method.
Results: From 2009 to 2018, 3,450 patients with PC were identified; the predominant profile of multiracial men (45.9%), with an average age of 72 years, no family history of cancer (39.6%), clinical stage II (57.70%), low Gleason score <=6 (52 .7%) and PSA level <10 ng/ml (40.9%). The probability of survival was estimated at 36, 48, and 60 months. Longer survival was found in men aged <60 - 36 (95% CI: 97); 48 (95% CI: 96); 60 (95% CI: 96). Gleason score: <=6 - 36 (95% CI: 98); 48 (95% CI: 97); 60 (95% CI: 96). Stage I: 36 (95% CI: 99); 48 (95% CI: 99); 60 (95% CI: 99). Initial treatment – Radiotherapy: 36 (95% CI: 97); 48 (95% CI: 96); 60 (95% CI: 96). PSA: <10 (ng/ml) 36 (95% CI: 99); 48 (95% CI: 98); 60 (95% CI: 98).
Conclusion: The individuals evaluated in this study had survival rates at 60 months higher than those observed in the national and world average for PC and prognostic factors, age >70 years, stage III and IV, elevated Gleason, and PSA >10 ng/ml. The results allow the use of new early diagnosis and treatment measures in the public network – Unified Health System (SUS), as well as proposing new control strategies and health promotion actions, aiming to reduce the morbidity and mortality of patients with PC.
Keywords: Prostate cancer, survival, epidemiology