Retrospective Analysis of Complications from Prostate Cancer among Nigerians

Abstract

Background: Prostate cancer (PCa) may be asymptomatic at an early stage and may run an indolent course that requires minimal or no treatment. Early diagnosis through screening reduces the rate of advanced diseases. Whereas, in the western countries where screening is more prevalent, many presents early with a chance for curative treatment. In Africa, late presentation is often the case with palliative treatment sadly the only choice. Objective: To evaluate the associated complications in patients with prostate cancer and assess the Gleason’s grade as a risk factor for complications observed in patients with prostate cancer, in Port Harcourt, Rivers, Nigeria. Method and Methodology: This was a retrospective study carried out over ten years, between January 2011 and December 2020. All patients with histologically confirmed prostate cancer who presented to the University of Port Harcourt Teaching Hospital, Sophia clinic, and Rosivylle clinic were evaluated. The folders were retrieved and their age, presenting complaints, skeletal survey, and biopsy reports were evaluated. Patients with incomplete records were excluded from the study. These data were collated using Microsoft Excel 2016 version and they were analyzed using SPSS version 20. Results: There were 335 patients with PCa with a mean age of 68.71year. The commonest complication was urinary symptoms observed in 192 with urine retention 119(35.5%) and nephropathy 73(21.8%). The spine was the commonest site of bone spread observed in 160(47.8%) followed by the femur 62(18.5%). Anaemia was the next common. There was an association between age, presence of urinary symptoms, and bone involvement with the Gleason’s Grade. However, there was a strong association of the overall presence of complications with Gleason’s score. Conclusion: Men with prostate cancer tend to present with advanced disease in Port Harcourt. The most common presentation was lower urinary tract symptoms followed by low back pain. Complications are associated with high Gleason’s grade cancers. Screening may aid in early diagnosis and cure of the disease especially for men of African descent.