In Italy, as in other countries,2,3 health care is supported by regional protocols as well as institutional programs for PCa that aim to support and integrate international guidelines. Consequently, great variability in the timing of PCa management persists between different countries and even between different areas of the same country. For these reasons, the awareness that cancer care waiting time (WT) might be too long, especially in some regions, persists. Moreover, the impact of WT on oncological and functional outcomes in patients affected by PCa is still debated and data on this aspect are fragmentary and conflicting.
The National Research Council PCa monitoring project in Italy (Pros-IT CNR) is a multicenter and prospective study, aiming to monitor the quality of life in patients diagnosed with biopsy-verified PCa.4 The aim of our work was to evaluate the potential role of the WT (defined as the time between the diagnosis and the first treatment) in patients with PCa, analyzing the influence of individual and medical factors on WT and its impact on quality of life and oncological outcomes.
Our analyses yielded several noteworthy findings. First, in our study, the overall median WT was 93 days (Q1=55, Q3=140). Moreover, multivariable analysis suggests that age, clinical T stage, and provenance from Southern regions of Italy are factors associated with a WT higher than 90 days. Finally, the most important key finding of our work is that a WT higher than 90 days does not substantially impact on patient’s health, in terms of functional and oncological outcome.
Our results provide suggestions for further high-quality studies to assess the impact of WT at mid and long-term follow-up.
Written by: Mauro Gacci, MD, and Isabella Greco, MD, Department of Urology, Careggi University Hospital, Largo Brambilla, Florence, Italy
References:
- Mottet, P. Cornford, R.C.N. van den Bergh, E. Briers (Patient Representative), M. De Santis, S. Fanti et al. European Association of Urology (EAU) Oncological guidelines 2019, Prostate Cancer. Available at https://uroweb.org/guideline/prostate-cancer/.
- Danish Health and Medicines Authority. Cancer pathways, http://sundhedsstyrelsen.dk/en/health/widespread-diseases/cancer/cancer-pathways (2014, accessed 30 December 2014).
- NHS Executive. Referral Guidelines for Suspected Cancer. London: Department of Health, 2000.
- Noale M, Maggi S, Artibani W, Bassi PF, Bertoni F, Bracarda S et al. Pros-IT CNR: an Italian prostate cancer monitoring project. Aging Clin Exp Res. 2017 Apr;29(2):165-172.