Abstract
Aim: According to World Health Organization, prostate cancer is one of the increasing malignancies in men worldwide. This paper aims to describe the epidemiological, clinical, diagnostic, therapeutic, and evolutionary aspects of patients with early metastatic prostate cancer in a urology center in the city of Douala in Cameroon. Materials and Methods: It is a retrospective and descriptive study of 110 patients with prostate cancer that was immediately metastatic at diagnosis over a period of six years (from January 2014 to December 2020). Results: The average age of patients at diagnosis was 67.5 years (range: 45 years to 88 years) and 53.63% of patients had body mass indexes greater than 25. Disorders of the lower urinary tract were the main presenting complaint in 55.45% of cases, followed by bone and joint pain in 46.36% of cases. Digital rectal examination was suggestive of prostate cancer in 96.36% of cases with an average total prostatic specific antigen (PSAT) level of 676.9 ng/ml (range: 21.8 to 8832 ng/ml). The diagnosis was made through prostate biopsy in 57 (51.81%) patients or after palliative endoscopic resection of the prostate indicated for lower urinary tract symptoms or even acute urinary retention in 53 (48.18%) patients. Adenocarcinoma of the prostate was the main histologic type, and in 47.27% of cases, the tumor was poorly differentiated with a Gleason’s score of greater than 7. The sites of metastasis were mainly the lymph node (87.27%), bone (56.36%), and both (44.54%). The treatment was palliative and dominated by bilateral pulpectomy in 60% of cases and luteinizing hormone-releasing hormone agonists (Triptorelin 11.25 mg every 3 months) in 44 (40%) of cases. Conclusion: Prostate cancer is a real public health problem in developed countries but also in Africa, especially in Cameroon. It is aggressive cancer that is often diagnosed when metastasis has already occurred. Its management is essentially palliative.
Highlights
Prostate cancer is one of the malignant conditions whose prevalence is on the rise in men worldwide [1]
This study aimed to describe the clinical characteristics and outline the treatment delivered to patients with metastatic hormone-naïve prostate cancer and evaluate factors that may predict the survival of patients followed up in a specialized urology institution in the city of Douala, Cameroon
The findings of the digital rectal examination were indicative of prostate cancer in 106 (96.3%) patients
Summary
Prostate cancer is one of the malignant conditions whose prevalence is on the rise in men worldwide [1]. GLOBOCAN estimates of the incidence and associated mortality worldwide for 36 different types of cancer in 185 countries [2] It is the leading cause of cancer-related death among men in 46 countries, especially in Sub-Saharan Africa and the Caribbean. The basis for the treatment of metastatic prostate cancer at diagnosis is the knowledge of the natural history of the disease, the biology of the primary tumor, and its metastases. This is to improve the survival of patients with advanced disease [7]. This study aimed to describe the clinical characteristics and outline the treatment delivered to patients with metastatic hormone-naïve prostate cancer (mHNPC) and evaluate factors that may predict the survival of patients followed up in a specialized urology institution in the city of Douala, Cameroon
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