Nine out of 10 prostate cancer cases discussed by a multidisciplinary panel, fewer hospitalizations, a decrease in patients rehospitalized 30 days after surgery and greater appropriateness in therapies and tests. They are the main results of the activation of the Diagnostic therapeutic pathways (Pdta) for prostate cancer in 29 specialized centers throughout Italy, as part of the project ‘Prostate Cancer Team – a team of prostate cancer specialists‘, created with the non-conditioning contribution of Astellas Pharma and with the organizational support of Opt Spa, aimed at the ISO 9001:2015 certification of the Pdta by an independent international certification body. The data were illustrated this morning in Rome during an event promoted by Opt with the patronage of Europa Uomo and Siicp (Interdisciplinary Italian Society for Primary Care).
Patients who go to a center with Pdta of certified prostate cancer – explains a note – have the guarantee of timely acceptance, integrated and efficient, which makes use of highly qualified professionals and innovative and appropriate therapies. A real garrison of excellent skills for the diagnosis and treatment of prostate cancer. The value generated by the ‘regulation’ and certification of prostate cancer Pdtas was measured by Opt involving 18 multidisciplinary teams and 150 clinicians who contributed to collecting and monitoring over 80 indicators. “Multidisciplinarity, shared rules, performance indicators are the three key factors from which to start – he says Oreste Pitocchi, president of Opt Spa – to design and implement a governance model in healthcare, capable of meeting the needs and expectations of the three main stakeholders: patient, doctor, institutions”.
The percentage of low-risk patients who, thanks to the organization of the Pdta, have undergone tests that were avoidable for their profile, such as Tc and Pet, has dropped from 5-10% to 3% – emerges from the project – highlighting how clinical appropriateness and adherence to guidelines have improved. More than halved the average time from diagnosis to discussion of the case in multidisciplinarity: from 10-15 days to 6 days. Finally, the implementation of the multidisciplinary approach has led to a better and more balanced distribution of treatments, with a view to greater appropriateness of the radiotherapy and oncological therapeutic pathway and inclusion in active surveillance. Taking charge from a multidisciplinary perspective is ‘good’ for the patient, the clinician and the National Health Service, because working according to criteria of appropriateness also means spending less, the promoters point out. The project also highlighted the fundamental importance of an increasingly structured collaboration between the public and private sectors.
“There public-private partnerships in the health sector belongs to the vision of Astellas, a company that wants to respond to the health demand of patients and, at the same time, to the needs of public health to find resources to guarantee the sustainability of the national and regional health system – he declares Giuseppe Maduri, CEO of Astellas Pharma – The Prostate Cancer Team project for the certification of prostate cancer Pdtas represents a concrete tool for improving the management of patients with prostate cancer, standardizing procedures and optimizing available resources”.
“The certified Pdta is a dynamic tool, whose individual steps are monitored over time with measurable and objective parameters that make the effectiveness of the measures undertaken measurable over time – he underlines Domenico Bilancia, director of UOC Medical Oncology Ao S. Carlo di Potenza – Future objective of the multidisciplinary group of the San Carlo is the territorial extension of the Pdta with the involvement of provincial health agencies, general practitioners and integrated home care (Regional oncological network) with definition of care settings according to the complexity profile, taking into consideration the right of proximity of treatments”.
Thanks to the multidisciplinary team dedicated to prostate cancer, “we have guaranteed better prescribing appropriateness – he remarks Antonio Cardi, UOC Urology doctor at San Giovanni Addolorata in Rome – and highlighted a significant increase in surgical, radiotherapy and oncological services. In the face of a greater increase in volume, we were also able to manage waiting lists. We are currently among the top 10 Italian centers in terms of activity volumes”.
“Expertise, synergy, taking charge”. With these terms Matteo Ciuffreda, doctor Uoc Urology Asst Mantovasummarizes “the modern management of prostate cancer, which is slowly leading more and more Italian centers to the multidisciplinary management of this pathology, providing a guarantee of quality and efficiency of the diagnostic-therapeutic and assistance path, with the possibility of personalized treatment that aims not only to survival, but also to the quality of life”.
Also for Piercarlo Gentile, head of Radiotherapy at the San Pietro Fatebenefratelli Hospital in Rome“the implementation of the Pdta in our hospitals is perhaps the most ambitious challenge that Italian healthcare will have to face in the coming years. It is therefore necessary to involve not only healthcare professionals in this project, but also to convince the administrations to invest in technological equipment and spaces suitable for the realization of this project”.
The president of the Siicp, Ciro Nirofinally recalls how the Italian Interdisciplinary Society for Primary Care has “for some time been committed to ensuring that general medicine is recognized as having a specific role in the screening, diagnostics and post-treatment monitoring of oncological diseases and in particular of prostate cancer. The commitment is extended, through sharing with the various specialist figures, as achieved with the Cancer Institute of Bari, in the application of Pdta that can meet the needs of primary care medicine in the treatment of prostate cancer. also to the implementation of telemedicine and artificial intelligence”.
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