Introduction:

prostate cancer has the highest incidence among cancers in Uruguay. It is characterized by significant clinical and biological heterogeneity. In localized stages, radical treatments with surgery or radiotherapy, often combined with hormonal therapy, achieve excellent outcomes in most patients. However, there is no national evidence on the outcomes of these treatments. This study retrospectively evaluated the epidemiological characteristics and treatment efficacy in a cohort of patients from a national mutual healthcare institution, as well as the impact of decision-making through tumor boards.

Objectives:

to analyze the clinical and epidemiological characteristics and assess treatment efficacy in a cohort of prostate cancer patients managed by the Oncology Department of Servicio Médico Integral (SMI) over a four-year period.

Materials and methods:

a descriptive, observational, and retrospective study was conducted based on the review of medical records from 147 patients diagnosed with prostate cancer and treated at SMI.

Results:

In this descriptive study, 147 prostate cancer patients were analyzed, emphasizing the multidisciplinary approach to case management. All treatment decisions (100%) were discussed in a tumor board, reflecting an integrated care model. Most patients (87%) presented with localized disease at diagnosis, with a median age of 67 years. Diagnostic evaluations included digital rectal examination, PSA testing, and conventional imaging. Treatment options for localized stages included radiotherapy, radical prostatectomy, and active surveillance, selected based on clinical criteria. A low recurrence rate was observed at two-year follow-up, particularly among patients under active surveillance. Tumor board discussions played a key role in therapeutic decision-making. Five-year disease-free survival (DFS) showed no significant differences between radiotherapy and radical prostatectomy, with an overall rate of 82%. The incidence of second primary tumors was 12%, with kidney cancer being the most common. Age and disease stage influenced both treatment choice and outcomes.

Conclusion:

this study highlights the importance of multidisciplinary discussion, the adaptability of treatment approaches, and the need for continuous care in the management of prostate cancer in Uruguay.

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