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Clinical Presentation, Pathological Pattern and Treatment Options of Prostate Cancer at Al-Azhar University Hospitals Over the Last 30 Years
Abstract
Objective: To report the clinical presentation, pathological pattern and treatment options of Prostate Cancer (PCa) cases diagnosed at Al-Azhar University Hospitals, Cairo, Egypt over the last 30 years.
Patients and Methods: Case sheets and hospital records of 322 consecutive cases of prostate cancer (PCa) diagnosed over 30 years period in Al-Azhar University Hospitals (between January 1980 and December 2009) were retrospectively analyzed. One fourth of cases presented during the first 15 years from 1980 to 1994 (Group I), while the remaining majority were encountered in the following 15 years from 1995 to 2009 (Group II). Assessment included Digital Rectal Examination (DRE), Pelvi-Abdominal ultrasonography, transrectal ultrasonography (TRUS) guided prostate biopsy. Serum Prostatic Acid Phosphatase (PAP) was available for the first group, while Prostate Specific Antigen (PSA) was available only in the second group. Cases with advanced disease, pelvi-abdominal Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) and bone scan were also performed to assess staging.
Results: The mean age of patients was 66.2±7 years (range 52-85). At disease presentation 90% of patients were 60 years or above. Organ confined disease was encountered in 17% and 45% in Group I and Group II respectively. Common clinical presentations included Lower Urinary Tract Symptoms (LUTS) and urine retention. Radical prostatectomy was done in 4% of Group I and 21% of Group II. Most of non organ confined cases were treated by castration. At the end of follow up period 28.5% of cases were living, while the remaining were dead either because of tumour related causes (31%) or non tumour related causes (40%). The mean follow-up period of cases was 40.39 months.
Conclusion: In this cohort of cases from a tertiary care referral hospital, prostatic carcinoma is usually diagnosed late. The majority of patients presented with advanced disease where available modalities of treatment are still limited. A coordinated awareness program to educate people may be needed.
Patients and Methods: Case sheets and hospital records of 322 consecutive cases of prostate cancer (PCa) diagnosed over 30 years period in Al-Azhar University Hospitals (between January 1980 and December 2009) were retrospectively analyzed. One fourth of cases presented during the first 15 years from 1980 to 1994 (Group I), while the remaining majority were encountered in the following 15 years from 1995 to 2009 (Group II). Assessment included Digital Rectal Examination (DRE), Pelvi-Abdominal ultrasonography, transrectal ultrasonography (TRUS) guided prostate biopsy. Serum Prostatic Acid Phosphatase (PAP) was available for the first group, while Prostate Specific Antigen (PSA) was available only in the second group. Cases with advanced disease, pelvi-abdominal Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) and bone scan were also performed to assess staging.
Results: The mean age of patients was 66.2±7 years (range 52-85). At disease presentation 90% of patients were 60 years or above. Organ confined disease was encountered in 17% and 45% in Group I and Group II respectively. Common clinical presentations included Lower Urinary Tract Symptoms (LUTS) and urine retention. Radical prostatectomy was done in 4% of Group I and 21% of Group II. Most of non organ confined cases were treated by castration. At the end of follow up period 28.5% of cases were living, while the remaining were dead either because of tumour related causes (31%) or non tumour related causes (40%). The mean follow-up period of cases was 40.39 months.
Conclusion: In this cohort of cases from a tertiary care referral hospital, prostatic carcinoma is usually diagnosed late. The majority of patients presented with advanced disease where available modalities of treatment are still limited. A coordinated awareness program to educate people may be needed.
