Sains Malaysiana 50(5)(2021): 1367-1379

http://doi.org/10.17576/jsm-2021-5005-16

Survival Analysis and Prognostic Factors for Prostate Cancer Patients at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur

(Analisis Kemandirian dan Faktor Prognostik bagi Pesakit Kanser Prostat di Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur)

SHAMSUL AZHAR SHAH*, NORZAHER ISMAIL, SYAFIQ TAIB, SITI NOR MAT & NAZARUDIN SAFIAN

Department of Community Health, Hospital Canselor Tuanku Muhriz UKM-Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

Received: 17 July 2019/Accepted: 28 September 2020

ABSTRACT

Prostate cancer is the third commonest type of cancer in Malaysian men with the incidence of 1,807 in 2018 compared to 1,186 cases reported in 2014. Prostate cancer is also known to cause disease, economic burden and lead to significant financial implications for the healthcare system. This study aimed to measure the rate of survival and to determine the prognostic factors for prostate cancer patients at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur. This was a retrospective study design involving prostate cancer patients who had been diagnosed and had sought treatment at Universiti Kebangsaan Malaysia Medical Centre from 2008 to 2017. Data were obtained from the patients’ medical records based on TRUS biopsy. The study period was from July 2017 to December 2018. Survival probabilities were estimated using Kaplan-Meier, and differences were compared using the log-rank test. The adjusted hazard ratio (HR) for variables was estimated after fitting the Cox proportion hazard model. Patients' death status due to prostate cancer was the endpoint of the survival analysis. A total of 283 patients’ data were analysed. Total five-year and ten-year survival rates of prostate cancer patients were 77.8 and 65.5%, respectively, regardless of the stage and treatment. The predictor factors for survival age were ≥75 years (HR = 8.49, 95% C.I: 1.16-62.13), Gleason score ≥8 (HR = 2.36, 95% C.I: 1.18-4.73) and cancer metastasis complications (HR = 5.26, 95% C.I: 2.88-9.63). Survival rates and prognostic factors of prostate cancer in the study were almost similar to those in nearby countries in the region. Preventive actions such as prostate cancer screening, early detection of cancer and early treatment should be empowered to improve the survival rate of prostate cancer patients in this hospital.

Keywords: Prognostic factor; prostate cancer; survival analysis

ABSTRAK

Kanser prostat ialah jenis kanser yang ketiga tertinggi di kalangan lelaki Malaysia dengan kadar insiden 1,807 kes pada tahun 2018 berbanding 1,186 kes pada tahun 2014. Kanser prostat juga diketahui sebagai punca beban penyakit, beban ekonomi dan menyebabkan implikasi kewangan yang signifikan kepada sistem penjagaan kesihatan. Kajian ini bertujuan untuk mengukur kadar kemandirian dan menentukan faktor prognostik untuk pesakit kanser prostat di Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur. Reka bentuk kajian adalah retrospektif yang melibatkan pesakit kanser prostat yang telah didiagnos dan mendapatkan rawatan di UKMMC dari 2008 hingga 2017. Data diperoleh daripada rekod perubatan pesakit berdasarkan biopsi kelenjar prostat. Tempoh kajian adalah dari Julai 2017 sehingga Disember 2018. Kadar kemandirian dianggarkan menggunakan Kaplan-Meier dan perbezaannya dibandingkan dengan ujian Log-Rank. Nisbah Hazard untuk pemboleh ubah dianggarkan menggunakan Model Hazad Berkadaran Cox. Status kematian pesakit akibat kanser prostat adalah titik akhir analisis kemandirian hidup. Sebanyak 283 data pesakit dianalisis. Jumlah pesakit kanser prostat sepanjang 5 tahun dan 10 tahun adalah 77.8 dan 65.5% tanpa mengira tahap dan jenis rawatan. Faktor prognostik untuk kemandirian hidup adalah umur ≥ 75 tahun (NH = 8.49, 95% SK 1.16-62.13), skor Gleason ≥ 8 (NH = 2.36 95% SK 1.18-4.73) dan komplikasi metastasis kanser (NH = 5.26 95% SK 2.88 -9.63). Kadar kemandirian dan faktor prognostik kanser prostat dalam kajian ini hampir sama dengan negara berdekatan di rantau ini. Tindakan pencegahan seperti pemeriksaan kanser prostat, pengesanan awal kanser dan rawatan awal harus diberi fokus untuk meningkatkan kadar kemandirian hidup pesakit kanser prostat di hospital ini.

Kata kunci: Analisis kemandirian; faktor prognostik; kanser prostat

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*Corresponding author; email: drsham@ppukm.ukm.edu.my