Retrospective analysis of prognostic factors, management, and pattern of failure in Metastatic Prostatic Cancer in Assiut University Hospital in the last ten years | ||
| SECI Oncology Journal | ||
| Volume 10, Issue 2, May 2022, Pages 95-100 | ||
| Abstract | ||
| Background: Prostate cancer (PC) is the fourth most prevalent cancer among men in Egypt accounting for 3.5% of new cancer cases and 2.5 % of male cancer deaths; the metastatic disease affects 6% of new PC cases, with a 5-year survival rate of 29%. Because metastatic PC is less curable, its treatment options and outcomes are particularly important. Aim of work: To evaluate the Patients’ characteristics, prognostic factors, therapeutic modalities, treatment outcomes and failure pattern of metastatic prostatic cancer patients in Assiut University Hospital since 1/1/2009 to 1/1/2019. Patients and methods: During the study period (2009-2019); data from 111 patients with metastatic prostatic cancer in Assiut University Hospital was analyzed. Results: Mean age of patients is 71 years; performance status (PS) 2 was the most represented PS (59%). Fifty five percent of patients were non-smokers. About comorbidities, 30% of the patients had other systemic disorders. Urinary symptoms were the most common manifestations (72%). Prostatic adenocarcinoma was the most prevalent pathology. The most frequent Gleason score (GS) was GS 7 (30%). After androgen deprivation therapy (ADT); 58% of patients had stable disease. While progression occurred in 41%, with a median progression-free survival (PFS) of 11 months. Of those who progressed post castration 22% were treated with chemotherapy, with median PFS of 8 months. 70% of patients received palliative bone radiotherapy. The median overall survival (OS) of all cases was (66 months). Regarding prognostic factors: combined ADT had significantly improved median overall survival (68 months) than single drug (65 months). Patients with castrate resistant prostate cancer (CRPC) had significantly lower survival; reducing the chance of survival by 4.065 times. Performance status had no significant effect on survival. Conclusion: Our study on metastatic prostatic patients in Assiut university hospital as a model of patients in developing countries, has presented information about patient characteristics, some prognostic factors, treatment modalities and pattern of failure, showing that ADT was a successful first-line treatment with OS and PFS comparable to those in advanced nations. Combined hormonal treatment seems to be more effective than single therapy, while the diagnosis of CRPC worsens dis ease’s outcome. | ||
| Keywords | ||
| metastatic cancer prostate; patient characteristics; prognostic factors; management; pattern of failure | ||
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