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Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience

Received: 18 May 2019    Accepted: 24 August 2019    Published: 16 September 2019
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Abstract

Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the Lagos State University Teaching Hospital, Ikeja over a 4 year period. Methods: This was a retrospective study in which the clinical records of all patients diagnosed with mCRPC at the Lagos State University Teaching Hospital, Nigeria between June 2012 and June 2016 were retrieved and analyzed. Results: There were 30 patients with mCRPC within the study period. The mean age of the patients was 69years. There was a biochemical confirmation of castration resistance in most of the patients (86.7%). The mean serum Prostate Specific Antigen (PSA) at the time of diagnosis was 771ng/ml and the mean Gleason Score was 8. Antiandrogen withdrawal/substitution was the most common first line of management (72.4%), while the use of docetaxel based chemotherapy (36.8%) was the most common second line treatment. Only 13.3% were treated with the newer agents abiraterone and enzalutamide. Almost half of the patients (46.7%) needed additional treatment with radiotherapy and/or zoledronic acid for symptomatic osseous metastases. Antiandrogen withdrawal/substitution was not significantly associated with increased risk of death at 18 months. Conclusion: Appropriate optimization and sequencing of the limited available treatment options for mCRPC are vital to a satisfactory outcome in a resource poor setting. Antiandrogen withdrawal/substitution should be a consideration in the management of mCRPC patients in resource poor environments.

Published in International Journal of Clinical Urology (Volume 3, Issue 1)
DOI 10.11648/j.ijcu.20190301.16
Page(s) 22-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

mCRPC Management, Antiandrogen Withdrawal, Chemotherapy, Resource Poor

References
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[10] Scher HI, Beer TM, Higano CS, et al. Prostate Cancer Foundation/Department of Defense Prostate Cancer Clinical Trials Consortium. Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1-2 study. Lancet 2010; 375: 1437–46.
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Cite This Article
  • APA Style

    Olufunmilade Omisanjo, Olawale Ogunremi, Olufemi Ojewuyi, Fatai Balogun, Mofeyisayo Omorinde, et al. (2019). Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience. International Journal of Clinical Urology, 3(1), 22-26. https://doi.org/10.11648/j.ijcu.20190301.16

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    ACS Style

    Olufunmilade Omisanjo; Olawale Ogunremi; Olufemi Ojewuyi; Fatai Balogun; Mofeyisayo Omorinde, et al. Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience. Int. J. Clin. Urol. 2019, 3(1), 22-26. doi: 10.11648/j.ijcu.20190301.16

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    AMA Style

    Olufunmilade Omisanjo, Olawale Ogunremi, Olufemi Ojewuyi, Fatai Balogun, Mofeyisayo Omorinde, et al. Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience. Int J Clin Urol. 2019;3(1):22-26. doi: 10.11648/j.ijcu.20190301.16

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  • @article{10.11648/j.ijcu.20190301.16,
      author = {Olufunmilade Omisanjo and Olawale Ogunremi and Olufemi Ojewuyi and Fatai Balogun and Mofeyisayo Omorinde and Stephen Ikuerowo},
      title = {Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience},
      journal = {International Journal of Clinical Urology},
      volume = {3},
      number = {1},
      pages = {22-26},
      doi = {10.11648/j.ijcu.20190301.16},
      url = {https://doi.org/10.11648/j.ijcu.20190301.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20190301.16},
      abstract = {Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the Lagos State University Teaching Hospital, Ikeja over a 4 year period. Methods: This was a retrospective study in which the clinical records of all patients diagnosed with mCRPC at the Lagos State University Teaching Hospital, Nigeria between June 2012 and June 2016 were retrieved and analyzed. Results: There were 30 patients with mCRPC within the study period. The mean age of the patients was 69years. There was a biochemical confirmation of castration resistance in most of the patients (86.7%). The mean serum Prostate Specific Antigen (PSA) at the time of diagnosis was 771ng/ml and the mean Gleason Score was 8. Antiandrogen withdrawal/substitution was the most common first line of management (72.4%), while the use of docetaxel based chemotherapy (36.8%) was the most common second line treatment. Only 13.3% were treated with the newer agents abiraterone and enzalutamide. Almost half of the patients (46.7%) needed additional treatment with radiotherapy and/or zoledronic acid for symptomatic osseous metastases. Antiandrogen withdrawal/substitution was not significantly associated with increased risk of death at 18 months. Conclusion: Appropriate optimization and sequencing of the limited available treatment options for mCRPC are vital to a satisfactory outcome in a resource poor setting. Antiandrogen withdrawal/substitution should be a consideration in the management of mCRPC patients in resource poor environments.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Optimizing the Treatment Options for Metastatic Castration Resistant Prostate Cancer in a Resource Poor Setting: A Single Centre Experience
    AU  - Olufunmilade Omisanjo
    AU  - Olawale Ogunremi
    AU  - Olufemi Ojewuyi
    AU  - Fatai Balogun
    AU  - Mofeyisayo Omorinde
    AU  - Stephen Ikuerowo
    Y1  - 2019/09/16
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcu.20190301.16
    DO  - 10.11648/j.ijcu.20190301.16
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 22
    EP  - 26
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20190301.16
    AB  - Background: Metastatic Castration Resistant Prostate Cancer (mCRPC) is invariably a terminal disease. Though international guidelines exist on mCRPC management, there are varied practices regarding the sequencing of limited available treatment options locally. Objectives: To describe the treatment sequence and outcome of management of mCRPC at the Lagos State University Teaching Hospital, Ikeja over a 4 year period. Methods: This was a retrospective study in which the clinical records of all patients diagnosed with mCRPC at the Lagos State University Teaching Hospital, Nigeria between June 2012 and June 2016 were retrieved and analyzed. Results: There were 30 patients with mCRPC within the study period. The mean age of the patients was 69years. There was a biochemical confirmation of castration resistance in most of the patients (86.7%). The mean serum Prostate Specific Antigen (PSA) at the time of diagnosis was 771ng/ml and the mean Gleason Score was 8. Antiandrogen withdrawal/substitution was the most common first line of management (72.4%), while the use of docetaxel based chemotherapy (36.8%) was the most common second line treatment. Only 13.3% were treated with the newer agents abiraterone and enzalutamide. Almost half of the patients (46.7%) needed additional treatment with radiotherapy and/or zoledronic acid for symptomatic osseous metastases. Antiandrogen withdrawal/substitution was not significantly associated with increased risk of death at 18 months. Conclusion: Appropriate optimization and sequencing of the limited available treatment options for mCRPC are vital to a satisfactory outcome in a resource poor setting. Antiandrogen withdrawal/substitution should be a consideration in the management of mCRPC patients in resource poor environments.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Department of Surgery, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria

  • Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

  • Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

  • Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

  • Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

  • Department of Surgery, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria

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