Características clínicas del paciente que debuta con cáncer de próstata metastásico en el Hospital San Juan de Dios durante el periodo comprendido entre 2019 y 2022
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2024
Autores
Dennise Monge Cedeño
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Introducción : Los datos epidemiológicos sobre el cáncer de próstata en Costa Rica son escasos y se desconoce el patrón de comportamiento en el estadio clínico castrato sensible metastásico. El objetivo del estudio fue analizar las características clínicas, epidemiológicas y la efectividad del tratamiento de la población con esta patología en el Hospital San Juan de Dios durante el año 2019 al 2022.
Métodos: Este estudio fue unicéntrico, observacional, retrospectivo y de cohorte en el que se analizaron los expedientes clínicos de los pacientes que debutaron con cáncer de próstata metastásico castrato sensible dentro del periodo 2019 al 2022.
Resultados: De la población analizada (n=758), 71 pacientes (9%) presentaron diagnóstico de cáncer de próstata metastásico castrato sensible; 41 de ellos (57%) con un alto volumen de enfermedad. Como tratamiento, 36 pacientes (50,7%) recibieron terapia anti androgénica en monoterapia. De los pacientes que recibieron terapia combinada en dupleta, 28 (39,4%) recibieron docetaxel, 6 (8,5%) asociaron el uso de abiraterona y solo 1 (1,41%) recibió enzalutamida. El grupo observado tuvo una mediana de progresión a la castrato resistencia de 23,3 meses (95% IC: 17,4-28,3) y una mediana de supervivencia general no alcanzada. Aquellos que recibieron terapia combinada tuvieron una supervivencia libre de progresión de 25,3 meses comparado a 17,8 meses en el grupo de monoterapia (HR: 0,74; 95% IC: 0,44- 1,36 p=0,43). La tasa de supervivencia global al año fue de 65,8% para el grupo que recibió deprivación androgénica sola vs 72,7% en la terapia combinada (p=0,41).
Conclusión: Este estudio representa el primer análisis descriptivo realizado en Costa Rica que explora las características clínicas de los pacientes con cáncer de próstata metastásico sensible a la castración, así como los patrones de progresión y las tendencias de tratamiento en esta población. Además, se evaluó la supervivencia global según el medicamento administrado.
Introduction: Epidemiological data on prostate cancer in Costa Rica are scarce and the pattern of behavior in the metastatic castration-sensitive clinical stage is unknown. The objective of the study was to analyze the clinical, epidemiological characteristics and the effectiveness of the treatment of the population with this pathology at the Hospital San Juan de Dios during the year 2019 to 2022. Methods: This study was a single-center, observational, retrospective and cohort in which the clinical records of patients who debuted with castrate-sensitive metastatic prostate cancer were analyzed within the period 2019 to 2022. Results: Of the population analyzed (n=758), 71 patients (9%) were diagnosed with metastatic castration – sensitive prostate cancer; 41 of them (57%) with a high- volume disease. As treatment, 36 patients (50.7%) received anti-androgen therapy as monotherapy. Of the patients who received combined therapy, 28 (39.4%) received docetaxel, 6 (8.5%) associated the use of abiraterone and only 1 (1.41%) received enzalutamide. The observed group had a median progression to castration resistance of 23.3 months (95% CI: 17.4-28.3) and a median overall survival not reached. Those who received combination therapy had a progression-free survival of 25.3 months compared to 17.8 months in the monotherapy group (HR: 0.74; 95% CI: 0.44-1.36 p=0.43). The overall survival rate at one year was 65.8% for the group that received androgen deprivation alone vs. 72.7% in the combination therapy (p=0.41). Conclusion: This study represents the first descriptive analysis conducted in Costa Rica exploring the clinical characteristics of patients with metastatic castration- sensitive prostate cancer, as well as the patterns of progression and treatment trends in this population. Additionally, global survival was evaluated based on the administered medication.
Introduction: Epidemiological data on prostate cancer in Costa Rica are scarce and the pattern of behavior in the metastatic castration-sensitive clinical stage is unknown. The objective of the study was to analyze the clinical, epidemiological characteristics and the effectiveness of the treatment of the population with this pathology at the Hospital San Juan de Dios during the year 2019 to 2022. Methods: This study was a single-center, observational, retrospective and cohort in which the clinical records of patients who debuted with castrate-sensitive metastatic prostate cancer were analyzed within the period 2019 to 2022. Results: Of the population analyzed (n=758), 71 patients (9%) were diagnosed with metastatic castration – sensitive prostate cancer; 41 of them (57%) with a high- volume disease. As treatment, 36 patients (50.7%) received anti-androgen therapy as monotherapy. Of the patients who received combined therapy, 28 (39.4%) received docetaxel, 6 (8.5%) associated the use of abiraterone and only 1 (1.41%) received enzalutamide. The observed group had a median progression to castration resistance of 23.3 months (95% CI: 17.4-28.3) and a median overall survival not reached. Those who received combination therapy had a progression-free survival of 25.3 months compared to 17.8 months in the monotherapy group (HR: 0.74; 95% CI: 0.44-1.36 p=0.43). The overall survival rate at one year was 65.8% for the group that received androgen deprivation alone vs. 72.7% in the combination therapy (p=0.41). Conclusion: This study represents the first descriptive analysis conducted in Costa Rica exploring the clinical characteristics of patients with metastatic castration- sensitive prostate cancer, as well as the patterns of progression and treatment trends in this population. Additionally, global survival was evaluated based on the administered medication.