الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Prostate cancer is a common cancer in males, it is the second most common cancer in male and the 5th cause of cancer deaths worldwide. Treatment of metastatic prostate cancer includes androgen deprivation therapy, palliative radiotherapy, chemotherapy, and supportive treatment. Metastatic prostate cancer form about 6% of new PCa cases, with a 5-yr survival rate of only 29%. Metastatic PCa often becomes androgen independent, which contributes to its poor prognosis. The incidence of metastatic PCa is of great interest, as this form of the disease is less amenable to treatment. The goal of this study is to analyze patient characteristics and result of metastatic prostate cancer cases presented to Assiut university hospital in the period from 1/1/2009 to 1/1/2019 by studying the pattern of metastatic prostate cancer, epidemiology, pathology, patients’ characteristics, treatment modalities and treatment outcomes. The study was on 111 cases of metastatic prostate cancer patients received treatment at Assiut university hospital and has been identified patient and disease characteristics (age, occupation, smoking, p.s, presenting symptoms, associated diseases, pathology, and Gleason grade of the tumor), treatment received, progression free survival. With exclusion of any patient not continued treatment. It was found that: The incidence of metastatic prostate cancer in oncology department in Assiut university is 1.24%.The mean age is 71 years, with most cases (73%) in age group 63 to 83 years old. Performance status of patients was founded to be mainly P.S; 2 (59.5%) and (28.8%) were P.S 3. 55% of patients were nonsmokers and 45% were smokers. 70% had no other chronic disease, 30% had other chronic diseases, of them the most found chronic diseases were hypertension and diabetes mellitus. The most common presenting symptoms were urinary tract complaints in 52% of cases, then bone pain in 23% of cases. The majority of cases had prostatic adenocarcinoma (95.5%).Most patients presented with high volume metastasis: (65%) of cases, (35%) presented with low volume metastasis. Majority of metastasis were bone metastasis (73%) of cases. All patients received androgen deprivation therapy in the form of; surgical castration with Bicalutamide in 48.6% of patients, surgical castration with Ceproterone acetate in 7.2% of patients, surgical castration alone in 1.9% of patients, Goserline in 8.1%, Combined Goserline and bicalutamide in 34.2%.Among cases assessed for response to hormonal treatment; in 58% disease was stable (no progression), while disease progression occurred in 41% who were diagnosed to have CRPC by assessment of testosterone level. The median of Progression free survival (PFS) of patients received hormonal deprivation therapy was 11 months Survival is significantly affected in CRPC. CRPC decreased survival chance by 4.065. Patients who progressed to CRPC received chemotherapy treatment; they were 24 cases (22%) received chemotherapy in the form of combination of (Docetaxel/prednisolone) Median PFS after chemotherapy was found to be 8 months. 70% of patients received palliative bone radiotherapy classified as following; *40% received radiotherapy dose of 30 gray; *30% received radiotherapy dose of 20 gray. Doses of 30gray and 20gray had the same effect on pain palliation. At the end of the study period, 65 cases (58%) were alive, 42 cases (38%) died, considering 4 (4%) cases were missed before completing therapy. In conclusion, this study provides information about metastatic prostate cancer in Assiut university hospital in specific time period (10 years from 2009 till 2019), it presented information about patient characteristics, some prognostic factors, treatment modalities and pattern of failure.