Comparación de tratamientos quirúrgicos y no quirúrgicos en pacientes con cáncer de próstata en SOLCA, Cuenca (2014-2021)

Abstract

Prostate cancer is one of the leading causes of morbidity and mortality among men worldwide and represents a significant public health problem in Ecuador. The objective of this study was to compare the clinical outcomes and adverse effects of surgical and non-surgical treatments in patients with prostate cancer treated at SOLCA between 2014 and 2021. An observational, analytical, retrospective, and cross-sectional study was conducted in 385 patients, collecting sociodemographic and clinical variables, adverse effects, and complications according to tumor stage. Descriptive analyses and the Chi-square test were applied. The mean age was 69 years, with a predominance of married patients, basic education, and urban residence. PSA levels mainly corresponded to intermediate-risk (40.5%) and very-high-risk (37.4%) categories. Early recurrence was significantly associated with chemotherapy (median of 1 year; p=0.041), particularly in advanced stages. Prostatectomy was associated with a high frequency of erectile dysfunction (71–88%) and urinary incontinence (30–43%). Among patients treated with radiotherapy and hormonal therapy, diarrhea, dysuria, and fatigue were the predominant adverse effects, while chemotherapy was associated with a higher frequency of nausea, vomiting, and neuropathy. Patients undergoing prostatectomy had a lower frequency of medical consultations and polypharmacy compared with those receiving other treatments. These findings demonstrate relevant differences in clinical outcomes and treatment-related toxicity among therapeutic modalities according to disease stage.