PRIMARY PROSTATE CANCER : CLINICAL PROFILE AND THERAPEUTIC OUTCOMES AT NOUAKCHOTT FRIENDSHIP HOSPITAL

Medicine

Currently, prostate cancer represents a public health issue, with its frequency varying from one country to another. Objective : Our work aimed to study the epidemiological, clinical, and therapeutic data of prostate cancer at the urology department of Amitié Hospital in Nouakchott, Mauritania. Material and methods : It was a retrospective and descriptive study focusing on prostate cancer cases recorded from the hospitalization registers of Amitié Hospital in Nouakchott. The study period spanned 5 years (2015 to 2020). The parameters studied included: the patient's age at the time of diagnosis, family history, clinical presentation, pre-therapeutic PSA levels, radiological investigations, histopathological examination results from various types of samples, clinical TNM classification, therapeutic data, and patient outcomes. Results : The incidence of prostate cancer in the urology department was 20 cases per year. The average age of patients was 71.17 years (ranging from 50 to 90 years). The age group of 70 to 79 years was the most represented, observed in 57% of patients. The most common reason for consultation was lower urinary tract symptoms in 66 patients, accounting for 73%. Rectal examination was suspicious in 66 patients, representing 71% of cases. The average PSA level was 142.5 ng/ml (ranging from 3 to 1800 ng/ml). Ultrasound findings were mostly unremarkable. Twelve patients had a heterogeneous prostate, corresponding to 13%. Adenocarcinoma was the histological type observed in all patients. Among them, 66% were diagnosed from resection chips, 28% from prostate biopsy, and 6% following prostatic adenomectomy. Regarding prognosis, Gleason scores of 7 or higher accounted for 94% of cases (n = 84). Among the 90 patients, 73 had metastases: 5 lymph node, 13 bone, 34 lymph node and bone, and 1 patient had lymph node, bone, and pulmonary metastases. Various therapeutic procedures performed on our patients included continuous hormone therapy in 27 patients, intermittent hormone therapy in 8, pulpectomy in 43, and radio-hormone therapy in 12. Seventy-two patients, or 80%, survived more than 3 years, while 17 patients, or 19%, died before 2 years. One patient was lost to follow-up. Conclusion : Prostate cancer is common and has a poor prognosis in our country. Implementing an individual screening policy would represent a definite advantage in improving prognosis.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.