Organization of cancer care for patients with cancers of male genito-urinary organs in Ukraine
Fedorenko Z.P., Gulak L.O., Gorokh Ye.L., Sumkina O.V., Kutsenko L.B.
Summary. A comprehensive study of a cohort of male patients with malignant neoplasms of genito-urinary organs recorded and stored in the National Cancer Registry of Ukraine to assess and evaluate cancer care activities. It was found, that the highest number of cases in the cohort constitutes cancers of prostate gland with a crude rate 41.00/0000 in 2015; the second-highest are cancers of urinary bladder — 20.60/0000 and on the third place are cancers of kidney — 16.50/0000. Site-specific analysis showed that for cancers of prostate percentage of cases received surgical treatment decreased from 45.0% in 2005 to 39.0% in 2015; for kidney and bladder cancers percentage of cases treated only surgically increased from 40.2 to 51.9% and from 34.8 to 47.2%, respectively, while reducing the use of a combined and complex approach. The specifics of the treatment procedures given patients with prostate cancer is a conciderable percentage of accompanied hormone therapy (23.9%), while in bladder cancers it is chemo- and radiotherapy as a part of complex treatment (36.1%). The majority of patients (>50%) receive treatment in specialized oncological institutions or general medical institutions with cancer beds; 5–10% patients received treatment in scientific and research institutions’ clinics; almost 30% of patients received primary treatment in general medical institutions without oncological beds and these institutions are not able to provide compliance with unified clinical protocols of medical care of cancer patients. This results in 20–25% difference in 5-year survival rates depending on institution providing cancer treatment, and these rates are sufficiently lower comparing to European countries. Five-year population-based survival rates were 51.9% for prostate cancers, 42.5% — for kidney cancers and 54.7% — for urinary bladder cancers. Region-specific analysis showed 5-year survival rates for prostate cancers were only 21.2% in Rivnenska oblast, 30.6% — in Chernihivska and 32.3% — in Zhytomyrska; kidney-cancer 5-year survival rates were 37.8% — in Chernivetska, 35.2% — in Ternopilska and 38.7% — in Zakarpatska; urinary bladder 5-year survival rates were 32.7% in Rivnenska, 41.4% — in Ternopilska. At the same time 5-year survival rates in Eastern European countries are 72.8% for prostate, 57.6% — for kidney and 63.8% — for urinary bladder and in Nordic countries these rates are 84.3; 55.3 and 72.1%, respectively.
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