Observational study of surgical treatment of prostate cancer in Iraq

Abstract

Author(s): Waleed Khalid Yaseen*

Prostate cancer is the second prevalent cancer in man, and its incidence is steadily rising. The study aimed to observed features of prostate cancer and surgical treatment modalities in Iraq. A retrospective observational study, conducted among patients diagnosed with PC, at Medical City. Data were retrospectively documented from the medical files of cases who were diagnosed with PC from March 2018 to March 2022. Males, who were diagnosed and confirmed adenocarcinoma of the prostate and received at least one prostate-specific treatment either surgery or radiotherapy. Demographics age and ethnicity, family history, clinical states, and comorbidities, histological PC type, TNM stage, Gleason score, risk group, and baseline PSA level were collected. Totally, 115 patients who met the eligibility criteria were included. The majority of patients showed localized or locally advanced tumor (69, 60.00%), whereas metastatic cases were (46, 40.00%). Hypertension found in PC and metastatic as (53 (76.81%) versus 38 (82.61%)), diabetes (41 (59.42%) versus 22 (47.82%)), and ischemic heart disease (6 (8.69%) versus 7 (15.22%)) were the most common comorbidities. Overall, most patients were diagnosed at stage III (40, 57.97%). Patients with metastatic PC were mainly detected at stage IV (78.26%). Most patients have GS under 6 (30, 43.48%) in localized tumors. All patients with localized disease have mean PSA 336.26±102.75 ng/mL and the mean PSA values for metastasis cases was 1304.54±78.53 ng/mL with significant difference (p=0.05). Among patients with localized/locally advanced PC, radical prostatectomy done in 19(27.53%), robotic prostatectomy 12(17.39%), bilateral orchiectomy 5(7.24%) and surgical castration 15(21.74%). However, 18 cases did not undergo surgery. In conclusion, most patients were diagnosed at moderately advanced or advanced TNM. Patients with localized/locally advanced PC were most commonly treated with radical prostatectomy. Patients with metastatic disease were most commonly untreated with surgery. These data reflect the challenge in managing metastatic patients.

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