Report of Radical Prostatectomy at the Urology Department of the Hopital General de Grand Yoff (HOGGY)
DOI:
https://doi.org/10.12970/2310-984X.2016.04.01.4Keywords:
Prostate cancer, localized, radical prostatectomy and evolution.Abstract
Goal: To show the importance of radical prostatectomy and to evaluate the carcinogenic and functional results of radical prostatectomy (RP) at the Department of Urology of the Hôpital General de Grand Yoff. Patients and Methods: This is a retrospective descriptive study involving 52 patients that had prostate cancer and had gone through RP. The study was held at the Department of Urology of the Hôpital General de Grand Yoff in Dakar over a period of 9 years starting from 1st January 2005 to 31st December 2014. The parameters covered in this study included: Age, existence or non-existence of history of prostate cancer in siblings, circumstances of diagnosis, clinical examination, diagnostic data with histology, therapeutic aspects and prognosis. All data was analyzed using CSPro and EXCEL software with the level of significance at (p < 0.005). Results: The average age of our patients was 61.2 years, ranging between the ages of 50 years and 69 years. In total, 51 patients had a preoperative Gleason score. Amongst them, 26 patients had well differentiated tumors (3+3 =6) and 7 patients had poorly differentiated tumors (4+4 =8) whilst 18 patients showed intermediate tumor differentiation between the two preceding groups (3+4 =7). Histological examination of the specimen among the patients with a preoperative Gleason score of 7 (3 + 4), only 4 of the predicted patients had a definite score of 7 (4 + 3) while 1 patient had a Gleason score of 8. Postoperative Gleason score was evaluated only in 23 of the patients. Post-operative complications included 30 cases of urinary incontinence (56%), one case of ED in 20 cases (37%) and ureteral-bladder stenosis in 4 cases (7%). Biochemical recurrence (BR) was found in 11 patients. We noted clinical recurrence (CR) in 4 of the patients. Among patients with an RB, the resection margins were positive in 2 patients and lymph node invasion in 2 patients. It was equally noted that there was a seminal vesicle invasion in 5 patients in the biochemical recurrence. In the 31 patients being followed up, quality of life was evaluated. Among patients with erectile dysfunction, 15 patients (48.4%) had good erectile functioning while 16 patients (51.6%) were evaluated as satisfactory. Continence was good in 11 patients (38.7%), average in 16 patients (51.6%) and poor in 3 patients (9.7%). Conclusion: Radical prostatectomy gives patients a better chance for cure. The proposition for a PSA of the patients over 50 years of age would increase early diagnosis and would improve the prognosis of the cancer.References
[1] Grosclaude P, Monenegoz F, Schaffer P, et al. Dépistage du cancer de la prostate. Prog Urol 2004; 7: 647.
[2] Valeri A, Malavaud B, Desrichard O, et al. Stratégies de diagnostic précoce et de prévention du cancer de la prostate. Bull Cancer 2010; 97(12): 1499-512.
[3] Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014; 64: 9-29. https://doi.org/10.3322/caac.21208
[4] HAS/ Service des maladies chroniques et dispositifs d’accompagnement des malades. INCa/ Département des recommandations pour les professionnels de santé. Guide ALD n° 30: Cancer de la prostate. Révision Janvier 2012. Consulté le 1er février 2015.
[5] Jalloh M, Niang L, Ndoye M, Labou I, Gueye SM. Prostate Cancer in Sub Saharan Africa. Journal of Nephrology and Urology Research 2013; 1: 15-20. https://doi.org/10.12970/2310-984x.2013.01.01.4
[6] Fournier G, Valeri A, Mangin P, Cussenot O. Le cancer de la prostate, facteurs de risque Anatomopathologie. Ann Urol 2004; 38: 187-206. https://doi.org/10.1016/j.anuro.2004.07.001
[7] Soulié M, Beuzeboc P, Cornud F, et al. Recommandations de l'AFU en onco-urologie. Cancer de la prostate. Prog Urol, 2007; 17: 1159-230. https://doi.org/10.1016/S1166-7087(07)74785-1
[8] Ammani A, Janane A, Chafiki J, et al. Profil épidémiologique du cancer de la prostate dans le service d’urologie de l’hôpital Mohammed V de rabat. J Maroc Urol 2007; 5: 11-14.
[9] Ndoye M, Niang L, Gandaho KI, et al. Cancer avancé de la prostate au Sénégal, les aspects cliniques à l’hopital Général de Grand Yoff. Prog Urol 2014; 25(5): 271-5. https://doi.org/10.1016/j.purol.2013.08.317
[10] Catalona WJ, Richie JP, Ahmann FR, et al. Comparaison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer. J Urol 1994; 151: 1283-90.
[11] Qarro A, Ghoundale O, Bazine K, et al. Score de Gleason des biopsies prostatiques et celui des pièces de prostatectomies: Quelle corrélation? Afr J Urol 2012; 18: 183- 8. https://doi.org/10.1016/j.afju.2012.06.006
[12] Delahunt B, Miller RJ, Srigley JR, Evans AJ, Samaratunga H. Gleason grading: past, present and future. Histopathology 2012; 60: 75-6. https://doi.org/10.1111/j.1365-2559.2011.04003.x
[13] Sarr A, Sow Y, Thiam I, Fall B, Diao B, Fall PA, et al. Détection précoce du cancer de la prostate chez le quadragénaire au Sénégal. Prog Urol 2011; 21: 260-3. https://doi.org/10.1016/j.purol.2010.05.011
[14] Salmon L, Bastide C, Beuzeboc P, et al. Recommandations du CCAFU en uro-oncologie 2013: cancer de la prostate. Prog Urol 2013; 24(2 suppl): S23-56.
[15] Fromont G. Difficultés d’interprétation des biopsies prostatiques: introduction. Ann Pathol 2012; 32: 105-6. https://doi.org/10.1016/j.annpat.2012.02.012
[16] Mignard J-P. Prostate biopsy. Prog Urol 2010; 20: 818-21. https://doi.org/10.1016/j.purol.2010.07.006
[17] Chan TY, Partin AW, Walsh PC, Epstein JI. Prognostic significance of Gleason score 3+4 versus Gleason score 4+3 tumor at radical prostatectomy. Urol 2000; 56: 823-7. https://doi.org/10.1016/S0090-4295(00)00753-6
[18] Prost J, Gros N, Bastide C, Bladou F, Serment G, Rossi D. Corrélation entre le score de gleason des biopsies prostatiques et celui de la pièce de prostatectomie radicale. Prog Urol 2001; 11: 45-8.
[19] Nwofor AM, Oranusi CK. Cancer of the prostate: Experience at Nnewi, Southeast Nigéria. Niger J Clin Pract 2004; 7: 65-8.
[20] Stamey TA, McNeal JE. Diagnosis of prostate cancer. In Campbell’s Urology. 6th ed. TSL Eds, Washington 2002; pp. 1197-9.
[21] Lance RS, Freidrichs PA, Kane C, et al. A comparison of radical retropubic with perineal prostatectomy for localized prostate cancer within the Uniformed Services Urology Research Group. BJU Int 2008; 87: 61-5. https://doi.org/10.1046/j.1464-410x.2001.00023.x
[22] Weldon VE, Tavel FR, Neuwirth H. Continence potency and morbidity after radical perineal prostatectomy. J Urol 1997; (3Pt2): 883-7.
[23] Steiner MS, Morton RA, Walsh PC. Impact of anatomical radical prostatectomy on urinary continence. J Urol 1991; 145: 512-5.
[24] Patrick J, Bastian MD, Mark L, et al. Clinical and Pathologic Outcome after Radical Prostatectomy for Prostate Cancer Patients with a Preoperative Gleason Sum of 8 to 10. Cancer 2006; 107(6): 1266.
