Niang L, Ndoye M, Ouattara A, Jalloh M, Labou M, Thiam I, Kouka S C, Diaw J J, Gueye S M
Service d'urologie-andrologie, hôpital Général-du-Grand-Yoff, BP 3270, Dakar, Sénégal.
Prog Urol. 2013 Jan;23(1):36-41. doi: 10.1016/j.purol.2012.09.002. Epub 2012 Oct 15.
To evaluate the management of patients with prostate cancer in Senegal.
We performed a retrospective descriptive study, based on the medical records of patients managed for prostate cancer during a period of six years and a half from January 1, 2004, to June 30, 2010. All records of inpatients and outpatients managed for prostate cancer were collected. Data collection was performed through a standardized survey form, and included the following parameters: age, presence or absence of known history of prostate cancer in siblings, circumstances of discovery, clinical and paraclinical examination, histology and therapeutic modalities.
We studied the records of 164 patients with prostate cancer. The mean age of our patients was 65years, ranging from 43 to 96years. The circumstances of diagnosis were mostly due to lower urinary tract symptoms. Digital rectal examination was suggestive in 87% of cases, and PSA levels were high in 100% of cases, ranging from 5.88ng/ml to 21,660ng/ml, with a mean of 1447.57ng/ml. Half of the patients had PSA levels greater than or equal to 100ng/ml. The most common histological type was adenocarcinoma. During the study period, 49 radical prostatectomies were performed. The mean PSA levels of patients who underwent a prostatectomy were 23.4ng/ml. Radical retropubic prostatectomy was performed in 35 patients, and radical perineal prostatectomy was performed in 10 cases. Pulpectomy was the method most commonly used in metastatic prostate cancer; it was performed in 48 patients. After resistance to castration, antiandrogens were reintroduced in 13 patients, and diethylstilbestrol in four patients. Only two patients underwent a taxane-based chemotherapy regimen.
The diagnosis of prostate cancer was usually tardive in Senegal. Treatment often involves surgical castration. Prostatectomy was only very seldom indicated.
评估塞内加尔前列腺癌患者的治疗情况。
我们进行了一项回顾性描述性研究，基于2004年1月1日至2010年6月30日这六年半期间接受前列腺癌治疗的患者的病历。收集了所有接受前列腺癌治疗的住院患者和门诊患者的记录。通过标准化调查问卷进行数据收集，包括以下参数：年龄、兄弟姐妹中有无前列腺癌已知病史、发现情况、临床和辅助检查、组织学及治疗方式。
我们研究了164例前列腺癌患者的记录。患者的平均年龄为65岁，年龄范围在43岁至96岁之间。诊断情况大多归因于下尿路症状。87%的病例直肠指检有提示意义，100%的病例前列腺特异抗原（PSA）水平升高，范围从5.88纳克/毫升至21,660纳克/毫升，平均为1447.57纳克/毫升。一半的患者PSA水平大于或等于100纳克/毫升。最常见的组织学类型是腺癌。在研究期间，进行了49例根治性前列腺切除术。接受前列腺切除术患者的平均PSA水平为23.4纳克/毫升。35例患者进行了耻骨后根治性前列腺切除术，10例患者进行了经会阴根治性前列腺切除术。去势术是转移性前列腺癌最常用的方法；48例患者接受了该手术。在去势抵抗后，13例患者重新使用抗雄激素药物，4例患者重新使用己烯雌酚。只有2例患者接受了基于紫杉烷的化疗方案。
在塞内加尔，前列腺癌的诊断通常较晚。治疗通常包括手术去势。前列腺切除术很少被采用。
