Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience
International Journal of Clinical Urology
Volume 3, Issue 1, June 2019, Pages: 22-26
Received: May 18, 2019;
Accepted: Aug. 24, 2019;
Published: Sep. 16, 2019
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Olufunmilade Omisanjo, Department of Surgery, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Olawale Ogunremi, Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Olufemi Ojewuyi, Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Fatai Balogun, Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Mofeyisayo Omorinde, Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Stephen Ikuerowo, Department of Surgery, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the Lagos State University Teaching Hospital, Ikeja over a 4 year period. Methods: This was a retrospective study in which the clinical records of all patients diagnosed with mCRPC at the Lagos State University Teaching Hospital, Nigeria between June 2012 and June 2016 were retrieved and analyzed. Results: There were 30 patients with mCRPC within the study period. The mean age of the patients was 69years. There was a biochemical confirmation of castration resistance in most of the patients (86.7%). The mean serum Prostate Specific Antigen (PSA) at the time of diagnosis was 771ng/ml and the mean Gleason Score was 8. Antiandrogen withdrawal/substitution was the most common first line of management (72.4%), while the use of docetaxel based chemotherapy (36.8%) was the most common second line treatment. Only 13.3% were treated with the newer agents abiraterone and enzalutamide. Almost half of the patients (46.7%) needed additional treatment with radiotherapy and/or zoledronic acid for symptomatic osseous metastases. Antiandrogen withdrawal/substitution was not significantly associated with increased risk of death at 18 months. Conclusion: Appropriate optimization and sequencing of the limited available treatment options for mCRPC are vital to a satisfactory outcome in a resource poor setting. Antiandrogen withdrawal/substitution should be a consideration in the management of mCRPC patients in resource poor environments.
Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience, International Journal of Clinical Urology.
Vol. 3, No. 1,
2019, pp. 22-26.
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