Prostate cancer: Experience at King Abdulaziz University Hospital, Jeddah

This paper presents the experience of King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, with prostatic cancer patients seen over a period of more than ten years (1986-1997). Fifty-five patients with confirmed diagnosis of prostate cancer were identified at KAUH during this period. Forty-seven presented primarily to KAUH and eight were referred from other centers for management and/or follow-up. Data analyzed included age at presentation, ethnic origin, mode of presentation, result of digital rectal examination (DRE), results of serum tumor markers, prostatic acid phosphatase, or prostatic specific antigen (PSA), results of transrectal ultrasonographic scan of the prostate (TRUS), methods and results of prostate biopsy, pathological grade of the cancer tissues, the clinical staging, and finally the type of treatment used. The average age at presentation was 68.8 years. Forty-one patients were white, six were black and the ethnic origin was not determined in eight patients. The main clinical presentation was by symptoms of prostatism in 36 patients (65%). DRE revealed benign prostatic hyperplasia (BPH) in 31 patients (56%) and suspicion of cancer in 24 (44%). Of the patients with adenocarcinoma of the prostate, 27 had PSA measurements, elevated above 20 ng/mL in 17 (63%). The tissues were obtained from the prostate by needle biopsy in 30 patients (transperineal approach in 17 and TRUS-guided in 13 patients), prostatectomy in 17 patients (open in one, and transurethral prostatic resection in 16 patients), and unspecified method in eight patients. TRUS performed on 18 patients showed hypoechoic nodules indicative of cancer in 11 patients and BPH or normal in seven patients. Clinical staging revealed 15 (27%) in stage A, 5 (9%) in stage B, 5 (9%) in stage C and 30 (55%) in stage D. During this period no retropubic radical prostatectomy operation aimed at curing localized prostate cancer was performed at KAUH, while bilateral orchiectomy for control of metastatic disease was done for 12 patients, and 18 patients received endocrine therapy.