Lutfi, Ahmad Firdaus Ahmad
(2020)
A retrospective study on survival analysis and its prognostic factors of prostate cancer patients in Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Prostate cancer is a leading cause of male morbidity and mortality globally and in
Malaysia. This study assessed the five-year survival and prognostic factors among prostate
cancer patients in Hospital USM, Kelantan.
Methodology: We reviewed 150 medical records of patients diagnosed with prostate cancer,
from 2009 to 2014. Survival time was analyzed in relation of patient demographics, Gleason
score, ASA classification, ECOG scores, PSA level, family history, cancer staging, cancerrelated
hematological parameters, and treatment method. Kaplan-Meier survival curves and Cox
proportional hazards models are used for the analysis.
Results: The prostate cancer five-year survival rate was 84.5%. Overall Kaplan-Meier survival
curve showed good median survival times. Univariate regression analysis revealed significant
prognostic factors including age (HR=1.06, 95% CI:1.00, 1.11, p=0.034), ASA 3 classification
(HR=3.72, 95% CI:1.38, 10.00, p=0.009), ECOG score 2 (HR=17.98, 95% CI:3.98, 81.1,
p<0.001), ECOG 3 (HR=33.94, 95% CI:7.41, 150.0, p<0.001), anemia (HR=9.07, 95% CI:3.33,
24.6, p<0.001), High LDH (HR=5.37, 95% CI:1.80, 15.90, p=0.003), High ALP (HR=8.94, 95%
CI:3.31, 24.1, p<0.001), Nodular staging (HR=5.87, 95% CI:1.74, 19.85, p=0.004), Metastasis
(HR=3.48, 95% CI:1.28, 9.44, p=0.014), Androgen Deprivation Therapy (HR= 0.29, 95%
CI:0.08, 0.99, p=0.05) and Chemotherapy (HR=4.57, 95% CI:1.79, 11.6, p=0.001).
Conclusion: The five-year survival rate of HUSM patients treated for prostate cancer was
84.5%. The survival rate reduces significantly due to prognostic factors like age, ASA
classification, ECOG score, some hematological parameters, cancer staging and chemotherapy.
However, patients received the ADT have a better survival rate, which suggests the main role of
prompt initiation of the therapy in improving patient survival.
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