TITLE:
Prostate Cancer: Risk Factors and Outcome Indicators
AUTHORS:
Cyril Kamadjou, Annie Kameni Wadeu, Jerry Kuitche, Achille Mbassi, Justin Kamga, Fru Angwafo
KEYWORDS:
Aggressive Prostate Cancer, Early Diagnosis, Transrectal Ultrasonography, Prostate Biopsy, Prognosis
JOURNAL NAME:
Surgical Science,
Vol.13 No.8,
August
30,
2022
ABSTRACT: Background: Prostate cancer, which is the second most frequent cancer diagnosis made
in men, more commonly occurs in the elderly. This disease is often diagnosed
late in resource-limited settings, which results in people having advanced
forms of the disease and a poor prognosis. This study aimed to identify factors
indicative of prostate cancer aggressivity and a poor prognosis in patients
with prostate cancer at a single center in Douala, Cameroon. Methods: We
performed a retrospective study from 2015 to 2020 at the Centre
medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85
years who had prostate cancer diagnosed via histopathology after either
prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data
analysis and logistic regression analyses were performed to identify factors
associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age
of our study participants was 64.76 ± 7.48
years. Ten patients had a contributive family history of prostate cancer. The
patients presented with lower urinary tract symptoms in 61.58% of cases. All
patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100
patients were anemic, and 36 patients had aggressive forms of the disease.
Eighty-eight patients had remarkable digital rectal
examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33
patients died during follow-up. The presence
of paraplegia and the practice of professions requiring unskilled labor
were significantly associated with aggressive prostate cancer. The presence of
lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic
echostructures were significantly associated with both prostate cancer
aggressivity and patients’ outcomes. Conclusion: The late diagnosis of
prostate cancer is a major public health problem in Cameroon because of the
complications and poor prognosis of the
disease at an advanced stage. Certain clinical, biological, and imaging
factors are associated with prostate cancer aggressivity and a poor prognosis,
whose identification could help guide clinicians in making therapeutic choices
for their patients.