Evaluation Of Surgical Castration For Prostate Cancer At Nnewi: Issues Regarding Follow-Up Of Cases

Abstract

Objective. To evaluate the average time of follow-up of patients with advanced prostate cancer after surgical castration and to assess the difficulties associated with follow-up of patients
Patients and Methods. 89 case notes of patients who had surgical castration for advanced prostate cancer were reviewed. Information on age, PSA values, tumor differentiation and the duration of follow-up were analyzed. Patients who failed to return for follow-up one year after their scheduled appointments to hospital were assumed lost to follow-up.
Results. The peak age incidence of the disease was in the 8th decade of life representing 43% of cases. The mean age was 69 ± 3.6years with a range of 40-89 years. 95.5% 0f the patients had associated co-morbidities. The commonest was hypertension (42.7%) followed by diabetes mellitus (28.1%). Others included arthritis (6.7%), hemorrhoids (6.7%), pneumonia (3.4%), asthma (3.4%), congestive cardiac failure (2.2%), inguinal hernia (2.2%), chronic obstructive airway disease (2.2%) and cataract (2.2%). 3.4% (3) had PSA values between 0-4ng/ml, 11.2% (10) had values between 5-9ng/ml, 20.2% (18) had values between 10-19ng/ml and 65.2% (58) had PSA values >20ng/ml. 44.9% (40) were poorly differentiated adenocarcinomas, 38.2%(34) were moderately well differentiated and 16.9%(15) were well differentiated adenocarcinomas. 9% of the patients were still on follow-up as at the time of conclusion of this study, 87.5% were lost to follow-up. 3.3% where confirmed dead.
The average duration of follow-up for patients with poorly differentiated tumors was 8.5 ± 2.1months (range 1-24months), while that for moderately well differentiated tumors was 22.5 ± 5.8months (range 1-36months) and 36.6 ± 16.1months (range 24-60 months) for those with well differentiated tumors.
Conclusion. This study highlights the difficulties associated with follow-up of patients with prostate cancer. The study shows that most of the patients are usually lost to follow-up after surgical castration. Assessment of survival after surgical castration for prostate cancer as well as deaths rates associated with prostate cancer may be difficult to assess in this environment.


Keywords: Surgical castration, follow-up, Co-morbidities.

Tropical Journal of Medical Research Vol. 12 (1) 2008: pp. 38-41