Repository logo
 
Publication

Prostate cancer progression: a scoping review, pharmacoeconomic assessment, and evaluation of quality of life

2025-10-30Research article Open access
Simple item page
dc.contributor.authorDinis de Sousa, Rute
dc.contributor.authorZagalo, Daniela Mariana
dc.contributor.authorGouveia, Miguel
dc.contributor.authorGomes, Luís
dc.contributor.authorSantos Dias, José
dc.contributor.authorMansinho, André
dc.contributor.authorSantos, Susana
dc.contributor.authorMariano, José
dc.contributor.authorCanhão, Helena
dc.contributor.authorRodrigues, Ana
dc.date.accessioned2025-11-12T10:55:21Z
dc.date.available2025-11-12T10:55:21Z
dc.date.issued2025-10-30
dc.description.abstractAIMS/BACKGROUND: Prostate cancer is the most common malignancy in men and a leading cause of cancer-related death. Progression from non-metastatic castration-resistant prostate cancer (nmCRPC) to metastatic CRPC (mCRPC) significantly worsens health-related quality of life (HRQoL), increases mortality, and raises healthcare costs. This study assessed the impact of avoiding or delaying progression to mCRPC on HRQoL, mortality, and economic outcomes, incorporating patients' lived experiences and unmet needs. METHODS: Three complementary studies were conducted. Study 1 was a scoping review of HRQoL and functional outcomes across disease stages, analyzing 56 studies (27 RCTs, 29 observational). Study 2 used a pharmacoeconomic survival-partition model of apalutamide, calibrated for the Portuguese healthcare system, to estimate utility gains, mortality impacts, and healthcare costs associated with delaying progression (excluding drug costs). Study 3 comprised two virtual focus groups (n?=?5) exploring patient experiences, including symptom burden, psychological impact, daily life disruption, coping strategies, and care-related unmet needs. RESULTS: High-risk nmCRPC patients had higher HRQoL and better function than mCRPC patients. Symptomatic mCRPC had the lowest HRQoL (EQ-5D 0.63-0.90 vs 0.85-0.86; FACT-P 93-123 vs 109-121). Delaying progression yielded an estimated utility gain of 0.192, reduced annual mortality (0.1% vs 19.1%), and 4.4-fold lower healthcare costs. Focus groups confirmed greater physical symptoms, emotional distress, and social disruption in mCRPC, while nmCRPC experiences centered on monitoring and uncertainty. Patients identified gaps in supportive care, including psychosocial, sexual, and functional needs. CONCLUSIONS: Delaying progression from nmCRPC to mCRPC confers substantial HRQoL, survival, and economic benefits. Patient perspectives highlight gaps in supportive care and the value of early targeted interventions. LIMITATIONS: Small qualitative sample, reliance on baseline HRQoL without longitudinal adjustment, heterogeneity across studies, and exclusion of nmCRPC treatment costs may limit generalizability and precision.eng
dc.identifier.citationDinis de Sousa, R., Zagalo, D. M., Gouveia, M., & Gomes, L. et al. (2025). Prostate cancer progression: a scoping review, pharmacoeconomic assessment, and evaluation of quality of life. Journal of Medical Economics, 28(1), 1910-1932. https://doi.org/10.1080/13696998.2025.2578100
dc.identifier.doi10.1080/13696998.2025.2578100
dc.identifier.eid105020618944
dc.identifier.issn1369-6998
dc.identifier.other5b4026f5-aca5-493b-aa52-8151c9b18c9c
dc.identifier.pmid41128722
dc.identifier.urihttp://hdl.handle.net/10400.14/55623
dc.identifier.wos001604964000001
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectDisease progression
dc.subjectHealth-related quality of life
dc.subjectMetastatic disease
dc.subjectPatient outcomes
dc.subjectPharmacoeconomics
dc.subjectProstate cancer
dc.subjectQualitative research
dc.titleProstate cancer progression: a scoping review, pharmacoeconomic assessment, and evaluation of quality of lifeeng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.endPage1932
oaire.citation.issue1
oaire.citation.startPage1910
oaire.citation.titleJournal of Medical Economics
oaire.citation.volume28
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
133129211.pdf
Size:
3.37 MB
Format:
Adobe Portable Document Format
Download

Collections

CUBE - Contribuições em Revistas Científicas / Contribution to Journals