Multidisciplinary management of prostate cancer patients: the PerSTEP data

Besides promoting the cultural and organizational switch to multidisciplinarity and

multiprofessionality in Italy, the educational project PerSTEP supported by the Italian
Society for Urologic Oncology (SIUrO) and the Board of Medical Oncology Directors
(CIPOMO) wanted to make a picture of the multidisciplinary activities performed by the
participating centers and start a discussion on the efficacy of the interdisciplinary
collaboration in the management of prostate cancer patients.
The 23 centers participating in PerSTEP were invited to collect and send the data of 3
months activity. Nineteen joined the call and gathered this information:
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number of patients with genito-urinary cancers (total and split for cancer site)
managed with a multidisciplinary approach (either in clinics or discussed in
tumor boards)
number of patients to whom the Multidisciplinary Team changed the stage
number of patients to whom the Multidisciplinary Team changed the therapeutic
and observational options
number of patients who had received partial or incorrect information in previous
consultations
number of patients who required psychological support

The patients with genito-urinary cancers managed with a multidisciplinary approach

were 1420. Prostate cancer patients were 920. Fourteen centers reported that the
multidisciplinary evaluation was effective in a better definition of the stage of the
patients. This happened in 80 cases (8.7%). Fifteen centers reported that the
multidisciplinary approach led to changing the therapeutic and observational options
that patients had received before. This happened in 153 cases (12.5%). Sixteen
centers reported that patients had received partial or incorrect information in previous
consultations. This happened in 197 cases (21.4%). Ten centers reported that patients
asked for psychological support after the multidisciplinary evaluation. This happened
in 86 cases (0.9%).
Despite the limitations of this data collection, PerSTEP centers wanted to see if the
interaction of urologists, radiation oncologists and medical oncologists, supported by
other specialists such as pathologists, psychologists and imaging specialists, could
prove effective in the management of prostate cancer patients and confirm the
theoretical assumption of the advantages of multidisciplinary working. Having said
this, further data on the way the centers work are needed to make a more detailed
picture and to support these preliminary interesting results. Last but not least, further
effort will be necessary to promote the cultural and organizational change towards a
multidisciplinary management of prostate cancer patients and overcome the barriers
towards multiprofessional team working effective for health professionals and patients.
A special thank to SANOFI for supporting the communication plan of PerSTEP