SURVIVAL AND ITS DETERMINANTS AMONG PROSTATE CANCER PATIENTS IN TIKUR AMBESSA SPECIALIZED HOSPITAL ADDIS ABABA ETHIOPIA, RETROSPECTIVE COHORT STUDY

Abstract

ABSTRACT Background: Prostate cancer incidence rate is faster growing with higher mortality in developing countries than developed countries and it is the most common cancer disease among men in both developed and developing countries. It is the 2nd most common cancer among men in Ethiopia and is the 4th cause cancer death in men. Few studies are conducted regarding to prostate cancer burden in Ethiopia. There is scarcity of information on survival time and its determinants’ among prostate cancer patients in the country. Hence, this study tried to estimate, survival and its determinants among prostate cancer patients, which in turn enables us to understand the survival of the patient. Objective: is to assess survival and its determinants among prostate cancer patients diagnosed during 2012-2016 at Tikur Anbessa specialized hospital (TASH) Addis Ababa, Ethiopia. Methods: prostate cancer patients diagnosed at oncology department of TASH were followed retrospectively by using retrospective cohort study design. All newly diagnosed cases during 2012-2016 were included in the study through obtaining their medical record numbers from cancer registry. Data extraction was performed by oncologic nurses from all retrieved patient charts by using checklist. The current event status was taken through phone call. Collected data were entered, cleaned and edited by Epi info version 7.1 and transferred to SPSS version 21 for analysis. Kaplan Meir survival analyses with log rank test were used to estimate probabilities of survival and to test for the presence of difference in survival among categories of covariates. Independent variables, which became significant during Bivariate Cox regression analysis at 20% level of significance was included in Cox proportional model for multivariable analysis. Independent variables whose p value were less than 0.05 during multivariable Cox regression analysis were considered as being the determinants of prostate cancer survival. Result: The median survival time was 30.7 months with overall survival of 22% at 5-years and 57% at 2-years. The five year survival rates for stage I, II, III and IV were, 83%, 61%, 16% and 0% respectively. The group of prostate cancer patients with distant metastasize and non metastasized have a five year survival of 0% and 44% respectively. Prostate cancer patients who were treated with ADT have 27% survival at five years while those who did not treated with ADT have had 7% survival rates. The stage of cancer, metastasize status and ADT treatment categories of covariates have significant difference in survival with 0.0001, 0.001 and 0.03 p values. Then stage of cancer (AHR 6.9, CI: 1.81-26.7) and androgen deprivation therapy (AHR 0.48, CI: 0.23-0.99) become significant on the final Cox proportional hazard model. Conclusions: The overall five year survival was 22% and covariates like stages of prostate cancer, distant metastatic status and ADT treatment modalities showed significant survival difference. Stages and ADT treatment modality were determinants of prostate cancer survival. In general our study shows poor survival or prognosis by late stage and treatments, indicating the key role of early detection and timely treatment for improving survival or reducing mortality from prostate cancer. Key words: prostate cancer, survival, Ethiopia