Clinical profile of stage D carcinoma of the prostate--a ten-year experience

Carcinoma of the prostate has become one of the top ten malignancies in Singapore but to date, there has been little local clinical data available on the disease. This study aims to establish the clinical profile of Stage D carcinoma of the prostate in the local population. Forty-seven patients with Stage D disease treated by the department over a ten-year period, 1981-90, were studied. The majority (47.7%) fell in the age-group 66-75 years and the most common presenting symptom was bone pain (36.2%). Both acid and alkaline phosphatases were found to be poor diagnostic markers of the extent of the disease. Acid phosphatase was not elevated in 25.0% and alkaline phosphatase not elevated in 39.1% of our patients. Forty of these patients had orchidectomy and of these, ten were also treated with oral stilbesterol. Five-year survival for the orchidectomy group was 22.7% and that for the orchidectomy-plus-stilbesterol group was 23.0%. This compares well with other studies done in the West. Eight patients died within the first year of diagnosis but of those who survived, all remained symptom-free within this first year. The proportion of those who remained symptom-free fell to 25.0% of the survivors for subsequent years.