Clinicopathological Features, Treatment, and Outcome of Omani Patients with Metastatic Prostate Cancer

Abstract

Objectives: Prostate cancer (PCa) is the third most common cancer worldwide, with its incidence rising in the Middle East. There is a paucity of data about the clinicopathological features and outcomes of metastatic prostate cancer (mPCa) from the Middle East. We report the outcomes of mPCa from Oman. Methods: We recruited consecutive men diagnosed with mPCa and treated at Sultan Qaboos University Hospital in Oman between January 2006 and December 2017. Information about demographics, clinical, laboratory, pathological, and radiological features at presentation, treatment, and survival outcomes was collected. Data were gathered until April 2019 or until the patient’s death for progression-free survival (PFS) and overall survival (OS), whichever came first. Survival rates were estimated using the Kaplan-Meier method. Univariate and multivariate analysis and Cox regression analyses were performed to study factors affecting the PFS and the OS. Results: Of the 239 men diagnosed with PCa over the study period, 62 were diagnosed with mPCa. The median age was 71 (range = 57–92) years. The majority of patients (61.3%) had a Gleason score ≥ 8. Median prostate-specific antigen (PSA) level was 100.0. Bone was the most common site of metastatic disease (90.3%). The majority of patients with the hormone-sensitive disease were treated with testosterone suppression only, while abiraterone, enzalutamide, and docetaxel were added for treating metastatic castration-resistant mPCa (mCRPC). After a median follow-up of 34.5 months, the median PFS was 17 months, while the median OS was 43 months. Median survival post mCRPC was 17 months. Conclusions: Omani patients with mPCa present with high PSA and Gleason score and with widespread metastatic disease burden. Treatments offered are according to internationally accepted standards and have comparable PFS and OS as reported elsewhere.

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