Survival Outcomes of Nigerian Men with Castration-Resistant Prostate Cancer: A Retrospective Cohort Study of men Managed at UITH, Ilorin.

Abstract

Introduction: Sub-Saharan African men are disproportionately impacted by higher stage and incurable forms of prostate cancer and they often progress to castration-resistant prostate cancer (CRPC). Despite this, very little is currently known about the disease's clinical course and survival in these men. This study interrogates mature survival data of a cohort of sub-Saharan African men with CRPC and describes the clinical course and survival. Methods: Using a strict selection algorithm, records of patients with CRPC as defined by the Prostate Cancer Working Group 2 managed in our institution from January 2013 to June 2018 were retrieved. Demographic, clinical and survival outcomes data were collected. The principal endpoint was the overall survival from the development of CRPC. The probability of survival was calculated using the Kaplan Meier method.Results: A total of 64 patients were identified. Median (IQR) age, PSA at CRPC diagnosis were 69 (64 -75.5) years and 42 (8.6-146.6) ng/mL respectively. About one-half (49.3%) of the patients had Gleason grade groups 4 and 5. Twenty-six patients (41.0%) received docetaxel (median cycles: 3, range: 1-6), only six patients (9.4%) received a biraterone, and none received enzalutamide, sipuleuce lT, cabazitaxel or radiopharmaceutical therapy. A total of 33 (51.6%) patients died during a median follow-up of 7 (IQR: 6-14) months and the median overall survival was 11 (95%CI:4-17) months.Conclusions: This study of African men with CRPC revealed only a small proportion receiving active treatments and poor survival in the cohort at only 11 months.