Survival and prognostic determinants of prostate cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A retrospective cohort study.
Adult
Aged
Aged, 80 and over
Androgen Antagonists
/ therapeutic use
Cancer Care Facilities
Ethiopia
/ epidemiology
Hospitals, Teaching
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Prognosis
Proportional Hazards Models
Prostatic Neoplasms
/ diagnosis
Retrospective Studies
Survival Rate
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
21
11
2018
accepted:
16
02
2020
entrez:
6
3
2020
pubmed:
7
3
2020
medline:
20
6
2020
Statut:
epublish
Résumé
Globally, the incidence of prostate cancer is increasing, particularly in low- and middle-income countries. It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. In Ethiopia, it is the second most common cause of cancer morbidity and mortality among men. Despite a few studies done regarding the disease burden, the evidence is scarce about the survival and prognostic determinants of prostate cancer patients in Ethiopia. Thus, this study assessed the survival and prognostic determinants of patients with prostate cancer. We retrospectively followed patients who were newly diagnosed from 2012 to 2016 at the Oncology Department of Tikur Anbessa Specialized Hospital. We extracted the data from patient charts that were available in the cancer registry using a checklist with the help of oncology nurses. Kaplan-Meier survival analyses with the log-rank test were used to estimate and compare the probability of survival among covariate categories. After checking for assumptions, a multivariable Cox regression analysis was performed to identify prognostic determinants of survival. The median survival time was 28 months with an overall 2-, 3- and 5-year survival of 57%, 38.9% and 22%, respectively. The overall survival differs according to the clinical stage (P-value<0.01), presence or absence of distant metastasis (P<0.01) and androgen deprivation therapy (ADT) (P<0.05). Cancer stage at diagnosis (adjusted hazard ratio (AHR) = 0.309, 95%CI = 0.151-0.633) and ADT (AHR = 3.884, 95%CI = 1.677-8.997) remained significant in the final Cox proportional hazards model. The overall 2-, 3- and 5-year survival of prostate cancer patients in Ethiopia is very low. The cancer stage at diagnosis and treatment modalities are significant prognostic determinants of survival. Therefore, early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients.
Sections du résumé
BACKGROUND
Globally, the incidence of prostate cancer is increasing, particularly in low- and middle-income countries. It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. In Ethiopia, it is the second most common cause of cancer morbidity and mortality among men. Despite a few studies done regarding the disease burden, the evidence is scarce about the survival and prognostic determinants of prostate cancer patients in Ethiopia. Thus, this study assessed the survival and prognostic determinants of patients with prostate cancer.
METHODS
We retrospectively followed patients who were newly diagnosed from 2012 to 2016 at the Oncology Department of Tikur Anbessa Specialized Hospital. We extracted the data from patient charts that were available in the cancer registry using a checklist with the help of oncology nurses. Kaplan-Meier survival analyses with the log-rank test were used to estimate and compare the probability of survival among covariate categories. After checking for assumptions, a multivariable Cox regression analysis was performed to identify prognostic determinants of survival.
RESULTS
The median survival time was 28 months with an overall 2-, 3- and 5-year survival of 57%, 38.9% and 22%, respectively. The overall survival differs according to the clinical stage (P-value<0.01), presence or absence of distant metastasis (P<0.01) and androgen deprivation therapy (ADT) (P<0.05). Cancer stage at diagnosis (adjusted hazard ratio (AHR) = 0.309, 95%CI = 0.151-0.633) and ADT (AHR = 3.884, 95%CI = 1.677-8.997) remained significant in the final Cox proportional hazards model.
CONCLUSIONS
The overall 2-, 3- and 5-year survival of prostate cancer patients in Ethiopia is very low. The cancer stage at diagnosis and treatment modalities are significant prognostic determinants of survival. Therefore, early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients.
Identifiants
pubmed: 32134996
doi: 10.1371/journal.pone.0229854
pii: PONE-D-18-33505
pmc: PMC7058322
doi:
Substances chimiques
Androgen Antagonists
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0229854Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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