Clinico-Pathologic Characteristics of Patients with Prostate Cancer and Outcome of Prostate Biopsy in a Nigerian Tertiary Hospital

Abstract

Background: Prostate cancer is considered the second most common malignancy worldwide and the fifth leading cause of cancer death. Its greatest mortality is among men of African descent. This study assessed the clinical and pathologic characteristics of patients diagnosed with prostate cancer and the outcome of prostate biopsy.

Methods: This was a cross-sectional study carried out from January 2015 to December 2016.  Consecutive patients presenting to Urology clinic with elevated prostate specific antigen >4ng/ml and /or abnormal digital rectal examination findings were included in this study and had digitally guided biopsy. Specimen were sent for histopathology and outcome recorded. The patients were also followed up, and complications of prostate biopsy documented. Data analysis was done using SPSS version 20.0.

Results: A total of 191 patients participated in this study. The majority (35.1%) of study participants were in the 60-69 age group with mean age of 68.2 ± 9.4 years. One hundred and eighty-one (94.8%) of patients had lower urinary tract symptoms. Forty-three patients (22.5%) had metastatic symptoms, with low back pain being the commonest (51.2%). Digital rectal examination findings were abnormal in 49.2% of patients. The cancer detection rate in the study was 40.3%. The majority (51.9%) of patients with adenocarcinoma of the prostate had Gleason score 5-7.  The commonest complication of prostate biopsy was hematuria occurring in 36.1% of patients, with 1% developing post biopsy sepsis.

Conclusion: A notable proportion of patients diagnosed of prostate cancer had advanced disease. Gleasons’ score parallels disease aggressiveness.