Организационные и клинические факторы выживаемости пациентов при раке предстательной железы в Свердловской области.

Abstract

Prostate cancer is included in the list of the most common forms of malignant neoplasms in men. The survival rate of the patients with prostate cancer depends on clinical and organizational factors. The network of express-diagnostic urological offices (EDUO) has been deployed in medical organizations of the Sverdlovsk region, designed for early diagnosis of urological and oncourological diseases, and determination of patient routing schemes. The purpose of the study: to determine the organizational and clinical factors of prostate cancer survival based on the data form the Sverdlovsk regional segment of the Russian oncological information system “ONCOR». Materials and methods. Data on all the 20087 newly identified cases of prostate cancer in the Sverdlovsk region in 2005–2022 were exported from the ONCOR database. One- and five-year tumor-specific survival rates were estimated by the life tables. The cumulative survival function was calculated by the Kaplan-Meyer method. Simple and multiple Cox regression analysis was used to find the relative risks of death of patients with prostate cancer depending on the clinical and organizational prognosis factors. Results. In 2005–2022, in the Sverdlovsk region, the level of primary morbidity rate of the male population with prostate cancer increased by +445.8%; 42.3% – 49.5% of cases were newly identified on the III and IV stages depending on the patient’s place of residence. The five–year tumor–specific survival rate of patients with I stage of prostate cancer was 87.4%, II stage – 77.4%, at the third III stage – 65.1%, IV stage – 23.6% (p < 0.001). The five–year tumor–specific survival rate of patients with prostate cancer confirmed in EDUO was 78.8%, in other medical organizations – 57.7%. The relative risk of death of the patient with prostate cancer depended on the place of residence, age, stage of the disease, as well as the availability of EDUO in the regional medical organization. Findings The results of the study confirm the effectiveness of the oncourological care model implemented in the Sverdlovsk region for patients with the prostate cancer.