尼日利亚西南部地区前列腺癌的负担。

Burden of prostate cancer in southwestern Nigeria.

机构信息

Department of Surgery; Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University; and Obafemi Awolowo University Teaching Hospital, Complex, Ile-Ife, Nigeria.

出版信息

Urology. 2010 Aug;76(2):412-6. doi: 10.1016/j.urology.2010.03.020. Epub 2010 May 7.

DOI:10.1016/j.urology.2010.03.020

PMID:20451979

Abstract

OBJECTIVES

To determine the pattern of presentation, prevalent age, hospital incidence, and outcome of management of prostate cancer in our environment.

METHOD

Patients with histopathology evidence of prostate cancer managed between January 1991 and December 2007 were studied. Information entered into a pro-forma sheet and analyzed included the age of patients, clinical features, investigations, histopathology diagnosis, outcome of management, and duration of follow-up.

RESULTS

During the period, 189 patients aged 46-99 years (mean, 68.0; 9.8 SD) confirmed and managed for prostate cancer were studied. The average hospital incidence (2002-2004) was 182.5 per 10(5) male admissions with 15.1-month mean duration of symptoms. Most 178 (94.2%) patients presented with advanced diseases, with 1 or multiple complications in 172 (91.0%), obstructive lower urinary tract symptoms 156 (82.5%), distant metastasis 97 (51.3%), lower back pain 95 (50.3%), weight loss 95 (50.3%), hematuria 86 (45.5%), anemia 77 (40.7%), renal failure 74 (39.2%), and inability to walk 42 (22.2%). Eighty-nine (47.0%) patients were farmers, 111 (58.7%) indulged in alcohol, and 46 (24.3%) smoked cigarettes. Mean prostate-specific antigen results available in 53 patients was 106.0 ng/mL (187.2SD) and digital rectal examination was valuable in diagnosis. Adenocarcinoma (186 [98.4%]) was the main histopathology type and most patients 136 (71.9%) had bilateral orchidectomy with or without antiandrogens. Mean duration of follow-up was 83.7 weeks.

CONCLUSIONS

The burden of prostate cancer in our developing community is worrisome. It is prevalent between 46 and 99 years in our community. Presentation is late, often with urinary retention and other complications. In our setting, treatment is still essentially palliative with orchidectomy, which we found to be beneficial, acceptable, and the most affordable to our patients.

摘要

目的

确定前列腺癌在我们环境中的表现模式、高发年龄、医院发病率和管理结果。

方法

研究了 1991 年 1 月至 2007 年 12 月间经组织病理学证实并接受前列腺癌治疗的患者。将患者的年龄、临床特征、检查、组织病理学诊断、管理结果和随访时间等信息输入到表格中进行分析。

结果

在此期间，研究了 189 名年龄在 46-99 岁（平均 68.0；9.8 SD）的确诊并接受前列腺癌治疗的患者。2002-2004 年平均医院发病率为每 10 5 名男性入院患者中有 182.5 例，症状平均持续时间为 15.1 个月。大多数 178 例（94.2%）患者表现为晚期疾病，172 例（91.0%）患者有 1 种或多种并发症，156 例（82.5%）患者出现阻塞性下尿路症状，97 例（51.3%）患者出现远处转移，95 例（50.3%）患者出现腰痛，95 例（50.3%）患者出现体重减轻，86 例（45.5%）患者出现血尿，77 例（40.7%）患者出现贫血，74 例（39.2%）患者出现肾功能衰竭，42 例（22.2%）患者出现无法行走。89 例（47.0%）患者为农民，111 例（58.7%）患者饮酒，46 例（24.3%）患者吸烟。53 例患者的平均前列腺特异性抗原结果为 106.0ng/mL（187.2SD），直肠指检对诊断有价值。腺癌（186 例[98.4%]）是主要的组织病理学类型，大多数患者（71.9%）接受了双侧睾丸切除术，伴或不伴抗雄激素治疗。平均随访时间为 83.7 周。