The Trends, Clinicopathological Features, and Treatment Outcomes of Patients with Prostate Cancer in Lokoja, Nigeria.

Abstract

Background: Prostate cancer (PCa) was the most common noncutaneous cancer among Nigerian men in 2020. Despite this high incidence, documented rates may be an underestimation.

Objectives: This study aimed to determine the hospital incidence rate, trends, and characterise the clinicopathologic features, and treatment outcomes of patients with PCa in our institution.

Materials and methods: A 5-year retrospective review of patients managed for PCa at the Federal Teaching Hospital, Lokoja (FTHL), Nigeria, from 2016 to 2020. Medical abstraction was done on clinicopathologic features, treatment received, serum prostate specific antigen (PSA) at diagnosis, 3, and 7 months of androgen deprivation therapy (ADT). Data obtained were analysed using SPSS 25, and trends analysis of the annual incidence rate and number of patients with PCa in the period was done using joinpoint regression modelling.

Results: Of 89 patients, 83 had complete medical records. The average annual hospital incidence rate was 174/100,000, and the mean age at diagnosis was 70.4 years. Locally advanced disease was found in 81.9% of patients, and tumours were ISUP grade groups 4 and 5 in 54.2% of patients. ADT was done in 62.6% of the patients, while 28.9% of the patients defaulted after diagnosis. The mean serum PSA was 71.9 ng/mL (7.7-156) at diagnosis and was 11.1 ng/mL (0.1-102) and 15.3 ng/mL at 3 and 7 months of ADT, respectively. Only 40.6% of the treated patients had a serum PSA ≤ 4 ng/mL at 7 months of ADT.

Conclusions: Patients with PCa in FTHL, Nigeria, have mostly locally advanced disease at diagnosis. Over half have a high-grade pattern and fail to achieve a serum PSA ≤ 4 ng/mL after 7 months of ADT.