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Al-Shehri, Al-Shaer, and Almansour: Treatment patterns in patients with metastatic prostate cancer at King Abdulaziz Medical City in Jeddah – a retrospective study

Introduction: Prostate cancer is the fifth most common cancer in men in Saudi Arabia. It accounts for 6% of all newly diagnosed cases among Saudi males. Approximately one-third of cases present at an advanced stage or develop metastatic disease after the initial definitive treatment. To our knowledge, there are no data available in Saudi Arabia on the treatment modalities or on the outcome of patients with metastatic prostate cancer.

Objectives: To evaluate treatment modalities and the outcome of patients with metastatic prostate cancer in patients attending King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia.

Materials and methods: The medical records at KAMC in Jeddah were searched to identify patients with metastatic prostate cancer. Patients aged ≥ 18 years with adenocarcinoma subtype who were treated at KAMC were included in this study.

Results: After exclusion of early and locally advanced cases, 80 cases with metastatic prostate cancer were identified. The median age was 71 years (range 44–90 years), the majority had a Gleason score ≥ 7; 83% (48/58 patients), median preoperative serum prostate-specific antigen level 177 μg/ml (range 5–2000). Bone metastasis were seen in 90% (n = 73) and visceral metastasis in 27% (n = 22). The median follow-up was 49 months (37–61 months). All patients received hormonal deprivation therapy (either luteinizing hormone-releasing hormone agonist or antiandrogen or both), around 27% (n = 22) underwent bilateral orchiectomy. Out of 81 patients, 22 received second-line therapy, either chemotherapy (docetaxel or mitoxantrone) or abiraterone acetate (Zytiga®, Janssen, Titusville, NJ, USA) or both. The median survival was significantly longer in patients who received second-line therapy than in patients who received best supportive treatment [29 months (95% confidence interval 15.4 to 42.5) vs. 15 months (95% confidence interval 12.3 to 17.6); P = 0.049].

Conclusions: The clinicopathological characteristics and outcome of patients with metastatic prostate cancer were comparable to previous findings. Second-line therapies improved the median survival time for those patients significantly.

Acknowledgements: Dr Mubarak Almansour for his great supervision in this project.

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