Clinicopathological features, treatment and outcome of Omani patients with localised prostate cancer

Objectives: To report the outcomes of Omani men diagnosed with localised prostate cancer (PCa), as PCa incidence is increasing in developing countries and there are scarce data regarding clinicopathological features and outcomes of PCa from the Arab world. Patients and methods: All men diagnosed with localised PCa between January 2006 and December 2017, and treated at a university hospital in Oman were included in the study. Data included demographic information, clinical, laboratory, pathological and radiological features at presentation, treatment modalities, and survival outcomes. Patients were followed until April 2019 or until death for disease-free survival (DFS) and overall survival (OS) whichever came first. Survival rates were estimated using the method of Kaplan and Meier. Univariate and multivariate analysis and Cox regression analyses were performed to study factors affecting DFS and OS. Results: Out of 239 men diagnosed with PCa over the study period, only 47 had localised disease (19.7%). The median age was 69 years. The majority (53.2%) had a Gleason score of ≥8 and a median (range) PSA level of 23.71 (range 0.6–452.9)ng/mL. In all, 16 patients received radical surgery, 17 received hormonal therapy along with definitive radiotherapy, while 15 were treated either with medical or surgical castration only. After a median follow-up of 43 months, the median DFS was 44.0 months. The median OS was not reached for the entire cohort. The 5- and 10-year OS rates were 84% and 57%, respectively Conclusion: Omani patients with localised PCa present with a high PSA level and a high Gleason score. Potentially curative treatments options, e.g. radical surgery and radiotherapy, are underutilised. The survival outcomes are similar to studies reported internationally. Abbreviations: (P)ADT: (primary) androgen-deprivation therapy; CAPRA: Cancer of the Prostate Risk Assessment; 3D: three-dimensional; DFS: disease-free survival; HDI: Human Development Index; Linacs, linear accelerators; NCCN: National Comprehensive Cancer Network; OS: overall survival; (m)(CR)PC: (metastatic) (castrate-resistant) prostate cancer; RP: radical prostatectomy; (IM)RT: (intensity modulated) radiotherapy; SQUH: Sultan Qaboos University Hospital.