einstein (São Paulo). 21/Nov/2022;20:eAO0049.

Radical prostatectomies for treatment of prostate cancer: trends in a ten-year period in public health services in the city of São Paulo, Brazil

Lucas Seiti Takemura ORCID logo , Álan Roger Gomes Barbosa ORCID logo , Breno Santos Amaral ORCID logo , Alvaro Alexandre Dias Bosco ORCID logo , Danilo Budib Lourenço ORCID logo , Marcelo Apezzato ORCID logo , João Arthur Brunhara Alves Barbosa ORCID logo , Eliney Ferreira Faria ORCID logo , Bianca Bianco ORCID logo , Gustavo Caserta Lemos ORCID logo , Arie Carneiro ORCID logo

DOI: 10.31744/einstein_journal/2022AO0049

ABSTRACT

Objective

To analyze the characteristics of public health services related to radical prostatectomy, according to hospital volume of surgeries and stratified as academic and non-academic centers.

Methods

An ecological study was conducted using a database available in TabNet platform of the Unified Health System Department of Informatics. Number of surgeries, length of hospital stay, length of stay in intensive care unit, in-hospital mortality rate, and cost of hospitalization were evaluated. The hospitals were divided into three subgroups according to surgery volume (tercile), and results were compared. The same comparisons were made among academic and non-academic centers. We considered academic centers those providing Urology residency program.

Results

A total of 11,259 radical prostatectomies were performed in the city of São Paulo between 2008 and 2018. We observed a significant trend of increase in radical prostatectomies for treating prostate cancer over the years (p=0.007). The length of stay in intensive care unit, and number of deaths were not statistically different among centers with diverse surgery volume, nor between academic and non-academic centers. However, length of hospital stay was significantly shorter in academic centers (p=0.043), while cost of hospitalization was significantly higher in high-volume center compared to low- (p<0.001) and intermediate-volume centers (p<0.001).

Conclusion

Length of hospital stay for radical prostatectomies performed in public services in the city of São Paulo was shorter in academic centers, whereas hospitals with a high volume of surgeries showed greater cost of hospitalization.

Radical prostatectomies for treatment of prostate cancer: trends in a ten-year period in public health services in the city of São Paulo, Brazil