[Prostate cancer: Quality assessment of clinical management in the Midi-Pyrenean region in 2011]

Abstract

Objectives: Assessing the quality of the clinical management of prostate cancer in the Midi-Pyrenean region in 2011.

Methods: The study population was randomly selected among new cases of prostate cancer presented in Multidisciplinary Team Meeting (MTM) in 2011. The indicators defined with the professionals have evaluated the quality of the diagnostic care, when treatment started and at the time of the MTM.

Results: Six hundred and thirty-three new patients were included (median age at diagnosis=69years, min: 48; max: 93). In diagnostic period, 92% of patients had a prostate biopsy. Performing a pelvic MRI, an abdomino-pelvic CT and bone scintigraphy concerned respectively 53%, 55% and 61% of intermediate or high-risk patients. The Gleason score, surgical margins and pathological stage were included in over 98% patient records treated by radical prostatectomy. A PSA assay in 3months after prostatectomy was found in 59% of surgical patients. The MTM was performed before treatment to 83% of patients. About three-quarters of surgical patients with stage pT≥3 or pN1 or with no healthy margins were discussed in MTM after surgery.

Conclusion: Most of the studied indicators reach a high level. However, the lower level of realization of complementary examinations may question about their real place, accessibility and traceability.

Level of evidence: 4.

Keywords: Cancer de la prostate; Diagnosis and clinical management; Diagnostic et traitement; Indicateurs de qualité; Multidisciplinarity; Pluridisciplinarité; Prostate Cancer; Quality indicators.