CHARACTERISTICS OF PROSTATE CANCER IN DR. HASAN SADIKIN

CENTRAL HOSPITAL IN JANUARY 2009 TO DECEMBER 2014

Herman Yudawan, TjahjodjatiDepartment of Urology,

Faculty of Medicine, Padjadjaran University Dr.Hasan Sadikin Hospital, Bandung

ABSTRACTIntroduction

These days, prostate cancer is the 4th most common non-dermatology malignancy in the western country in male, after skin, lung and colorectal malignancy

Early stage of prostate cancer usually present without any symptoms.

Suspicion towards prostate cancer increase with presence of other symptoms, ec: pathological fracture or spinal cord compression.

Therefore, PSA examination is recommended at age 50, while patient with family history is recommended to early detection at age 40.

Diagnosis of prostate cancer is depend on histopathological confirmation. Standard for prostate cancer treatment in Indonesia using age and stage as a parameter to determine treatment options.

ObjectiveTo know the description and characteristics of prostate cancer in Dr Hasan Sadikin Hospital in period Janry 2009-December 2014, that consist of age, PSA level, prostate volume, histopathological finding, gleason score, stage and therapy of prostate cancer patients.

Methods

This study is a descriptive and retrospective study with subject taken from patient’s medical record that treated in Urology division, department of surgery, Hasan Sadikin hospital.

Result

There were 134 patients with prostate cancer that treated in Hasan Sadikin hospital in January 2009-December 2014.

Most of the patients (130 patients, 97.01%) aged >50 years old, mean age was 66.8 years old.

PSA level 0-4, 3 patients (2.24%), 4-10, 10 patients (7.46%), PSA >10, 130 patients (90.30%)

Prostate volume 40 cc or less in 44 patients (32.84%), prostate volume more than 40 cc in 90 patients (67.16%)

Result From histopathological findings, found that

adenocarcinoma prostate in 133 patients (99.25%), meanwhile the other 1 (0.75%) with leiomyosarcoma of prostate

Gleason score <7 in 46 patients (34.44%), gleason score =7 in 38 patients (28.36%), and gleason score >7 in 46 patients (34.33%)

Prostate cancer in early stage (stage 1) in 8 patients (5.97%), stage 2a in 30 patients ( 22.39%), stage 2b in 48 patients (35.82%), stage 3 in 4 patients (2.99%) and stage 4 in 44 patients (32.84%)

Radical prostatectomy was done in 44 patients (32.84%), combination therapy of cystoscopy+TUR-P+ bilateral orchidectomy in 27 patients (20.15%), cystoscopy + TUR-P in 21 patients (15.67%) and hormonal therapy in 7 patients (5.22%).

Conclusion

Incidence of prostate cancer found most in age >50 years old, with mean age of 66.8 years old the most prostate volume was > 40cc with PSA >10

Most common histopathological finding was adenocarcinoma prostate with gleason score <7, in stage 2

Meanwhile radical prostatectomy still the most common treatment done for prostate cancer.

PREELIMINARYBackground Prostate cancer is currently the type of non-skin

malignancy in Western countries or the most common malignancy to 4 in men worldwide after skin cancer, lung and colon.

The most common form of prostate malignancy is adenocarcinoma of the prostate

Early-stage prostate cancer is often without symptoms Suspicion will increase with the presence of other

symptoms such as bone pain, pathologic fractures or bone marrow suppression. 

For that recommended PSA age 50, while having a family history recommended for early PSA is 40 years of age. 

The main examination in enforcing prostate cancer is a disease of travel history, digital rectal examination, serum PSA and transrectal ultrasonography / transabdominal.

Examination of PSA levels has changed the criteria for the diagnosis of prostate cancer. 

PSA is a serine-protease kallikrein that is almost entirely produced by prostate epithelial cells. In practice PSA is organ specific but not cancer-specific. 

PSA levels are sustainable parameters of the higher levels, the higher the suspicion of prostate cancer. 

The raw value of PSA in Indonesia currently used is 4 ng / ml.

Obtained a definite diagnosis of prostate biopsy results or specimen of prostate cancer surgery depend on the confirmation Histopathology.

Treatment of prostate cancer are based on tumor grading, staging, comorbidities, patient preferences, life expectancy at diagnosis. 

Considering the data ts to determine life expectancy at diagnosis are not in Indonesia, then used the age limit as one of the parameters to determine treatment options.

 Various characteristics can be identified from prostate cancer, which can be helpful in diagnosis, helps to determine the choice of therapy and determine prognosis.

 Based on the above, the authors are interested in doing research on the characteristics of prostate cancer in the General Hospital Hasan Sadikin in January 2009 to December 2014. In addition, this study could be the basis for further studies

Identification of Problems Based on the above issues can be identified

as follows: How do the characteristics of prostate cancer

at general Hospital Hasan SadikinPurpose and Objectives        The intent of this study is to get an idea

about the characteristics of prostate cancer in the General Hospital Hasan Sadikin.

       The research objective was to determine the characteristics of prostate cancer in the General Hospital Hasan Sadikin

Usability Research1. Aspects of Usability Studies

Provides the benefits of information and data about the characteristics of prostate cancer in the General Hospital Center for Hasan Sadikin hospital, the entire academic community of the Faculty of Medicine, University of Padjadjaran, lecturers, students, and future research.

2. Aspects of expected Results of this study are to provide information to the perpetrator of health care in hospitals in the urology field so that the results of this study can be used to detect variations in patients suffering from prostate cancer in the General Hospital Dr Hasan Sadikin

CHAPTER II

LITERATURE REVIEW