Prognostication Studies of Prostate Cancer in Black Africa: Findings from Calabar, South-South, Nigeria
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 5
Abstract
Introduction: Prostate cancer is the commonest cancer in males in Nigeria, a country with the largest concentration of indigenous black patients worldwide. The disease has variable clinical behavior but is noted to have a more aggressive course in blacks. Prognostication is important in detecting which patients have tumours with aggressive invasive potential bringing about proper patient management. This study was carried out to assess the outcomes in patients diagnosed with prostate cancer and the factors determining these outcomes. Material and Methods: This was a retrospective analysis of all histologically proven cases of prostate cancer at the University of Calabar Teaching Hospital, Nigeria over a 10- year period. Patients' demographic data, clinical condition and PSA at diagnosis and one year after, histologic diagnoses including Gleason’s grade and score, AJCC Stage, as well as treatment regimen were extracted. Data obtained was analyzed using Statistical Package for Social Sciences version 20. Results: One hundred and eleven (111) cases were studied with mean age of 66.7 ± 10.6 years. Most patients (70.2%) were within the 60-79 year age group. Over 64% of patients presented with Gleason grades of 3 or 4 and over 46% of patients had Gleason scores of 6 or 7. Fifty five percent of patients had PSA values greater than 20ng/mL and among these patients mean PSA was 62.3 ng/mL ± 26.6. Over 64% had at least stage 2B disease and above, metastasis was found in over 20% of patients at presentation and the main drug patients were placed on was Antiandrogens. Metastasis at presentation was found to be more common with age less than 60 years, Gleason Grade greater than 3, Gleason Score greater than 6 and AJCC Stage greater than 2B. Better treatment outcomes were recorded in patients older than 60 years of age, without metastasis at presentation and with AJCC Stage 2B or less. No significant difference in outcomes was noted between Gleason Grade less than or above 3 or scores less than or above 6. Significant loss in data was recorded in the study. Conclusion: A significant proportion of patients in our environment still present with advanced disease. Routine screening for prostate cancer is recommended and efforts at improving access to imaging modalities and electronic medical records should be intensified if better results in the management of prostate cancer must be achieved.
Authors and Affiliations
Ima-Abasi E. Bassey, Edoise M. Isiwele, Ayi Debua
Keywords
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