A 10-Year Experience of Prostate Cancer Management in Two Centers in Assiut

Background: Prostate cancer is the second most common cancer worldwide
and the fifth leading cause of cancer-related death 2022. In Egypt, it ranks
fourth, accounting for 7% of male cancers. Primary endpoint of this study was
to evaluate clinical and pathological characteristics, treatment protocol and
outcomes of patients with prostate cancer in two specialized oncology centers in
Assiut over 10 years, while secondary endpoints were DFS, PFS, and OS.
Ethical approval was obtained from the Faculty of Medicine, Assiut University
(IRB 04-2023-200109).
Methods: Retrospective review of patients from June 2013 to June 2023 was
conducted, collecting demographic data, clinicopathologic features, diagnostic
imaging, PSA levels, treatment lines, and follow-up information
Results: 100 were eligible. Stage III and IV disease observed in 26 and 74
patients, respectively. Treatment included radiotherapy (RT) in 68 patients,
prostatectomy in 1, and chemotherapy (docetaxel) in 9. Androgen deprivation
therapy was surgical in 2 and medical in 98. The median pretreatment PSA was
96.8 ng/mL, decreasing significantly post-treatment to 72.5 ng/mL. A
significant positive correlation existed between PSA decline at 3 months and OS
(r=0.221, p=0.031) and PFS (r=0.791, p<0.001). The median OS was 59
months; patients not receiving RT had higher mortality risk (HR=3), while
greater PSA decline was associated with lower mortality (HR=0.98). Median
PFS was 51 months, with similar predictors.
Conclusions: Radiotherapy offers a protective effect, and PSA decline serves as
a valuable prognostic indicator in prostate cancer outcomes