Abstract
Objective: To evaluate the factors predicting the time to progression to castration-resistant in metastatic prostate cancer under Androgen Deprivation Therapy (ADT) in our center. Patients and Methods: This is a retrospective, descriptive, analytical study in a single center over a period of 2 years. It has interest patients followed for metastasized prostate cancer under ADT. The parameters studied were: epidemiological, clinical, paraclinical, prostate specific antigen (PSA) nadir, time to nadir (TTN) and their link with the castration resistance. Results: The frequency of castration resistant prostate cancer was 28 patients per year. The mean age was 70.4 ± 7.9 years. An ECOG score ≥ 3 was more common as was the cT2c stage. The median of the initial total PSA was 489.6 ng/ml (203.3; 1653.2). All patients had adenocarcinoma. The International Society of Urological Pathology (ISUP) 1 was more frequent. Bone metastases were more frequent. The medians of nadir, TTN and the castration resistance were 19.3 ng/ml (3.7; 102.1), 5.5 months (3; 9) and 11 months (6; 15.3), respectively. The Eastern Cooperative Oncology Group (ECOG) score, clinical stage, metastatic site, the nadir and its TTN influenced the DSR. Age, lymph node involvement, initial total PSA and Gleason score did not influence the castration resistance. Conclusion: ADT should be initiated as soon as possible before an attack of general and/or clinical stage advanced to delay resistance. A drilling should be associated with this hormone therapy as much as possible because of its gain on resistance.
Highlights
Prostate cancer is the most common cancer in older men, the second leading cause of cancer death after lung cancer and the fourth leading cause of cancer death in the general population [1]
The objective of this study was to evaluate the factors predicting the time to progression to castration-resistant in metastatic prostate cancer under Androgen Deprivation
The data were collected on a survey form from the files of patients followed in consultation or hospitalized in our department for metastatic prostate cancer under hormone therapy
Summary
Prostate cancer is the most common cancer in older men, the second leading cause of cancer death after lung cancer and the fourth leading cause of cancer death in the general population [1]. In Senegal, most prostate cancers are diagnosed in locally advanced or metastatic stage [2] [3]. ADT the effects of which have been known for several years, is the cornerstone of the treatment of metastatic prostate cancer [4]. Ten to 20% of prostate cancers progress to castration-resistant prostate cancer (CRPC) within 5 years of diagnosis, and more than. The resistance to castration of metastatic prostate is likely to be treated with new molecule. The CRPC poses a therapeutic problem in developing countries because of the accessibility and cost of these new molecules used at this stage. The objective of this study was to evaluate the factors predicting the time to progression to castration-resistant in metastatic prostate cancer under Androgen Deprivation.
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