Retrospective descriptive study of radical prostatectomy for localised prostate cancer in Benin: epidemiological and diagnostic aspects over five years

Abstract

Objective: Prostate cancer is a major public health problem in sub-Saharan Africa. This study aims to provide a detailed analysis of the epidemiological characteristics and diagnostic aspects of patients undergoing radical prostatectomy for prostate cancer located at two university hospitals in southern Benin to improve the early management of this pathology in our context.

Methods: This was a monocentric, descriptive, retrospective study conducted over five years (1 January 2018 to 31 December 2022) at the University Urology and Andrology Clinic of Centre National Hospitalier Universitaire Hubert Koutoukou Maga (CNHU-HKM) in Cotonou and the Centre Hospitalier Universitaire Départemental de l’Ouémé-Plateau (CHUD-OP) surgical department. All patients who underwent radical prostatectomy for localised prostate cancer with complete clinical documentation were included. Incomplete records were excluded. Data were collected from patients’ medical records using a standardised collection form. Variables studied included sociodemographic data, history and comorbidities, clinical data including International Prostate Symptom Score (IPSS), results of biological (prostate-specific antigen [PSA]) and imaging tests, and anatomical pathology analyses. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 software.

Results: Of the 38 cases identified, 35 were selected according to our inclusion criteria. The mean age was 65 years. Most patients (57.1%) were asymptomatic. Among symptomatic patients, the mean IPSS was 12.3 ± 4.6, indicating moderate lower urinary tract symptoms (LUTS). On digital rectal examination (DRE), 71.4% of patients had an adenomatous prostate. The median PSA level was 14.6 ng/ml (range 4.6–62.5 ng/ml). Of the patients, 45.7% had PSA levels between 10 and 20 ng/ml. Pathological analyses revealed a predominance of Gleason score 6 (77.1%). TNM (tumour, node, and metastasis) analyses showed a majority of T2N0M0 stages (48.8%). Most patients (74.3%) had a low D’Amico score.

Conclusion: The epidemiological and diagnostic profile of patients undergoing radical prostatectomy in our setting is characterised by a predominance of forms with a good prognosis, diagnosed in patients in their 60s with few symptoms. These results suggest a gradual improvement in the early detection of prostate cancer in Benin, contrasting with the late presentation usually observed in developing countries. This trend could be attributed to increased awareness and better access to specialist urological care in our region, although further efforts are needed to optimise early detection and management.