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ABSTRACT
Introduction. Prostate cancer remains a significant health burden in sub-Saharan Africa, with most patients presenting at advanced stages. PSA nadir and time to PSA nadir (TTN) are emerging as key predictors of prognosis following androgen deprivation therapy (ADT), yet little data exists comparing these markers between non-metastatic locally advanced prostate cancer (LAPC) and metastatic hormone-sensitive prostate cancer (mHSPC) in African settings. The objective of our study was to evaluate and compare the prognostic significance of PSA nadir and TTN in patients with LAPC versus mHSPC treated with primary ADT in Cameroon. Methodology. We conducted a retrospective cohort study at two tertiary hospitals The study included data from January 1, 2020, to December 31, 2023 involving 240 patients with histologically confirmed LAPC or mHSPC. PSA kinetics, survival data, and clinicopathologic characteristics were analyzed. Results. A total of 240 patients met the inclusion criteria: 110 (45.8%) had non-metastatic locally advanced prostate cancer (LAPC) and 130 (54.2%) had metastatic hormone-sensitive prostate cancer (mHSPC). The mean age at diagnosis was 69.4 ± 7.2 years, with no significant difference between groups (p = 0.31). Median PSA nadir was significantly lower in LAPC (0.12 ng/mL) compared to mHSPC (0.24 ng/mL, p<0.001). TTN was also longer in LAPC (7.8 vs. 5.2 months, p<0.001). At 3 years, overall survival was 89.1% for LAPC and 72.3% for mHSPC (p<0.001). PSA nadir >0.2 ng/mL (AHR 2.87, p<0.001), TTN <6 months (AHR 1.96, p=0.008), and metastatic status (AHR 2.22, p=0.004) were independently associated with increased mortality. Conclusion. PSA nadir and TTN are strong prognostic indicators in HSPC.
RÉSUMÉ
Introduction. Le cancer de la prostate reste un fardeau sanitaire important en Afrique subsaharienne, la plupart des patients se présentant à un stade avancé. Le nadir du PSA et le temps écoulé jusqu'au nadir du PSA (TTN) apparaissent comme des indicateurs clés du pronostic après une thérapie de privation androgénique (ADT), mais il existe peu de données comparant ces marqueurs entre le cancer de la prostate localement avancé (LAPC) non métastatique et le cancer de la prostate hormono-sensible métastatique (mHSPC) dans les contextes africains. L'objectif de notre étude était d'évaluer et de comparer la signification pronostique du nadir du PSA et du TTN chez les patients atteints de LAPC et de mHSPC traités par ADT primaire au Cameroun. Méthodologie. Nous avons mené une étude de cohorte rétrospective dans deux hôpitaux tertiaires L'étude comprenait des données du 1er janvier 2020 au 31 décembre 2023 impliquant 240 patients atteints de LAPC ou de mHSPC histologiquement confirmés. La cinétique du PSA, les données de survie et les caractéristiques clinicopathologiques ont été analysées. Résultats. Au total, 240 patients ont été enregistré : 110 (45,8 %) avaient un cancer de la prostate localement avancé (CPLA) non métastatique et 130 (54,2 %) un cancer de la prostate hormono-sensible métastatique (CPHSm). L'âge moyen au moment du diagnostic était de 69,4 ± 7,2 ans, sans différence significative entre les groupes (p = 0,31). Le nadir médian du PSA était significativement plus bas dans le LAPC (0,12 ng/mL) que dans le mHSPC (0,24 ng/mL, p<0,001). Le TTN était également plus long dans le LAPC (7,8 vs. 5,2 mois, p<0,001). À 3 ans, la survie globale était de 89,1 % pour les LAPC et de 72,3 % pour les mHSPC (p<0,001). Le nadir du PSA >0,2 ng/mL (AHR 2,87, p<0,001), le TTN <6 mois (AHR 1,96, p=0,008) et le statut métastatique (AHR 2,22, p=0,004) étaient indépendamment associés à une mortalité accrue. Conclusion. Le nadir du PSA et le TTN sont des indicateurs pronostiques forts dans les HSPC.

Keywords

Prostate Cancer PSA Nadir Cameroon Time Hormone-sensitive Prostate Cancer Cameroun Temps Hormone sensible

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Tagang Titus Ngwa-Ebogo, Laah Njoyo Sylvain, Landry Oriol Mbouche, Manka’a Marie Louise, Azemafac Kareen Esenwoh, Ngongang Chiedjio Arielle, & Fru Forbuzshi Angwafo III. (2025). Prognostic Value of PSA Nadir and Time to PSA Nadir after Androgen Deprivation Therapy in Locally Advanced Versus Metastatic Hormone-Sensitive Prostate Cancer in Cameroon: Valeur Pronostique du Nadir du PSA et du Temps Écoulé avant le Nadir du PSA après la Thérapie de Privation Androgénique dans le Cancer de la Prostate Localement Avancé par Rapport au Cancer de la Prostate Métastatique Hormonosensible au Cameroun. HEALTH SCIENCES AND DISEASE, 26(6). https://doi.org/10.5281/hsd.v26i6.6704
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