OBJECTIVE - To review the mode of presentation and clinical course of patients with prostate cancer during a specified period, as the detection rate is tending to increase, with most patients presenting at an advanced stage, and yet the overall incidence and prevalence rates are low.
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METHODS - We retrospectively reviewed all aspects of care for patients who were diagnosed between May 2006 and July 2010.
RESULTS - In all, 76 men had a histologically confirmed prostatic adenocarcinoma diagnosed between May 2006 and July 2010 (mean age 71.1 years, SD 8). The median (range) prostate-specific antigen level at diagnosis was 52 (1.2-16,230) ng/mL. Of the patients, 74% had a Gleason grade of ⩾ 7 on diagnosis, and 64% had extraprostatic disease on presentation. Active surveillance was adopted in four patients, and four others were maintained on watchful waiting. Six patients had a radical prostatectomy, in one of whom it was a salvage procedure. Six patients received external-beam radical radiotherapy, five of whom had neoadjuvant, concurrent and adjuvant hormonal therapy. All remaining patients were treated primarily with androgen-deprivation therapy (ADT). Of the patients on hormonal manipulation, in 56% the cancer became castrate-resistant within the mean (SD) follow-up of 17.2 (15) months. Of patients treated primarily with ADT, 34% died. The death rate among the whole group was 23%. Both percentages include both prostate cancer-specific and non-specific mortality.
CONCLUSION - An advanced stage of disease at presentation mandates an early-detection, hospital-based screening programme. Further research should include many more patients and be based in several centres.
Arab J Urol. 2014 Sep;12(3):187-91. doi: 10.1016/j.aju.2014.04.003. Epub 2014 May 13.
Osman E1, Gomha MA1, Harb A1, Aldayel A1, Aloraifi I1, Almousa R1, Khan I1.
Urology Department, King Fahd Specialist Hospital, Dammam, Saudi Arabia.