Trends in patterns of care for prostatic cancer in Japan: statistics of 9 institutions for 5 years

Five hundred and sixty-five patients with prostatic cancer, who first visited 9 institutions in Japan between 1981 and 1985, were analyzed. The peak of age distribution was in the seventies. As clinical symptoms, disturbance on micturition was the most frequent and pain caused by metastasis was a complaint in approximately one tenth of the cases. Alkaline phosphatase measurement, prostatic biopsy, intravenous pyelography, bone scintigraphy, cystourethrography, and measurements of serum prostatic acid phosphatase and serum acid phosphatase were performed on more than 80% of the patients. The clinical stage was stage A1 in 6.2%, A2 in 3.7%, B in 14.9%, C in 20.7%, D1 in 7.4%, and D2 in 43.7%. According to the histological grade, well, moderately and poorly differentiated adenocarcinoma were observed in 20.4, 33.3 and 32.7%, respectively. Increased ratio of high grade to low grade was noticed in the lower age group as well as in the advanced stage. In this series, endocrine therapy was still accepted in most of the patients. Almost all were treated with hormonal medication and half of them had undergone bilateral orchiectomy. Surgery, radiation, chemotherapy or multidisciplinary therapy were attempted judging from the clinical stage and histological grade. However, old age restricted the therapeutic modality. Actuarial survival rate at 5 years for stage A1, A2, B, C, D1 and D2 was 89.2, 66.1, 72.7, 51.0, 47.5 and 28.0%, respectively. In the patients with stage D2, the 5-year actuarial rate of poorly differentiated adenocarcinoma was lower than that of well or moderately differentiated adenocarcinoma, even though more intensive therapy was given to the former.     

Clinical study on adenocarcinoma of the prostate

In 92 patients with prostatic carcinoma who were treated at the Takamatsu Red Cross Hospital from January 1976 to December 1985, we analyzed the age, chief complaint, degree of advancement, grade of tumor, way of therapy and prognosis. The age of the patients was between 51 and 87 years (mean: 74.8 years). The most frequent chief complaint was dysuria. In terms of the degree of advancement, 14 cases were assessed as Stage A, 23 cases as Stage B, 16 as Stage C and 39 as Stage D. Analysis of the grade of tumor disclosed that 38 cases (41.3%) had well differentiated adenocarcinoma, 20 cases (21.7%) had moderately differentiated adenocarcinoma and 29 cases (31.5%) poorly differentiated adenocarcinoma. Forty-four of the subjects have already died. The 5-year survival rate was 41.2% when calculated pursuant to life table method. The 5-year survival rate was 85.7% for Stage A, 36.1% for Stage B, 53.4% for Stage C and 24.3% for Stage D. The 5-year survival rate was 54.7% for well differentiated adenocarcinoma, 61.7% for moderately differentiated adenocarcinoma and 12.7% for poorly differentiated adenocarcinoma. Comparison of the 3-year survival rate among the 4 ways of therapy revealed only a small intergroup difference; namely, the rate was 58.5% for hormone therapy, 51.6% for intraarterial neocarzinostatin therapy, 77.1% for total prostatectomy and 57.1% for radiation therapy. These results indicate that our way of chemotherapy, which chiefly employs intraarterial administration of neocarzinostatin as an induction therapy, is at least comparable or superior to hormone therapy in terms of efficacy.     

Clinical study of prostate cancer--statistical analysis in the last 10 years

Fifty one cases of prostate cancer were treated at Yamaguchi University Hospital during 10 years since 1975. Age distribution was between 43 and 90 years old with an average of 70.9 years. Chief complaints were difficulty on micturition (33%), complete urinary retention (19.6%), macroscopic hematuria (15.7%), and frequency (13.7%). Clinical stage was classified as 1 case (2%) with stage A, 7 cases (13.7%) with stage B, 20 cases (39.2%) with stage C and 23 cases (45.1%) with stage D cancer. Histological grade was classified as 9 cases (17.6%) with well differentiated type of adenocarcinoma, 15 cases (29.4%) with moderately differentiated type and 27 cases (52.9%) with poorly differentiated type. The 5-year actual survival rate was 75% for stage A&B, 50% for stage C and 60% for stage D. The 10-year actual survival rate was 20% for stage A&B, 17% for stage C and 20.5% for stage D. There were no statistically significant differences between stage, grade and survival rate. According to specific cause 18 cases (58%) were cancer deaths including 8 cases (15.7%) of refractory disease, and 4 cases (12.9%) of cardiovascular complication. Five of the eight refractory cases could survive over one year by multimodal treatment. Local irradiation to prostate was most effective to control symptoms against locally refractory prostate cancer.     

青年与老年直肠癌临床对比分析

目的探讨青年与老年直肠癌的临床、病理及预后差异。方法中国医学科学院肿瘤医院自1990年1月至2000年1月收治40岁以下直肠癌患者138例（青年组），65岁以上者163例（老年组），对这组患者的病例资料进行生存分析和预后的多因素分析。结果青年组Ⅲ期直肠癌患者比例（53．6％，74／138）明显高于老年组（34.3％，55／163）；P=0．001；青年组中黏液腺癌和低分化腺癌患者比例（28．2％，39／138）也高于老年组（10．4％，17／163）P〈0．001。青年组和老年组5年生存率分别为50．4％和64．1％．两组比较差异有统计学意义（P〈0．05）；而按照TNM分期进一步分析显示．同期别两组的生存率差异均无统计学意义（P〉0．05）。多因素分析结果显示，肿瘤T分期（P=-0．001）和淋巴结转移（P〈0．05）是影响两组患者预后的独立因素。结论与老年直肠癌相比，青年直肠癌患者的病期较晚、肿瘤分化程度较低，影响其预后；但相同病期者生存率相似。早期诊疗是提高直肠癌总体生存率的关键。     

PTEN蛋白在前列腺癌中的表达及临床意义

目的　探讨PTEN蛋白表达与前列腺癌临床病理特征及临床分期的关系。方法　应用免疫组织化学法检测 3 2例前列腺癌及 5例良性前列腺增生组织中PTEN蛋白的表达。结果　 3 2例前列腺癌中有 8例 (2 5 .0 % )呈不同程度的阳性表达。随肿瘤细胞病理分级 ,临床分期增高 ,PTEN蛋白表达率降低 ,高分化组与中分化间表达率的差异无显著性 ,但高、中分化组与低分化组间的差异有显著性 (P <0 .0 5 )。在A、B期的表达率明显高于C、D期 (P <0 .0 5 )。结论　抑癌基因PTEN的表达缺乏在前列腺癌的发生、发展中起重要作用 ,检测PTEN蛋白的表达有助于判断病情及预后。     

Hormonal treatment of carcinoma of the prostate]

Efficacy of orchiectomy and intravenous administration of diethylstilbestrol diphosphate (DESP) for the treatment of prostatic carcinoma was evaluated on 184 patients treated between 1975 to 1989. The patients were between 49 to 88 years old with a mean age of 73.4 +/- 8.3 years. Clinical stage was A in 9.8%, B in 12%, C in 26.6% and D in 51.6%. The histologically well, moderately and poorly differentiated adenocarcinoma were observed in 20.9, 29.4 and 49.7%, respectively. The 5-year survival rate of stage A, B, C and D calculated with the Kaplan-Meier method were 90, 49, 60 and 34%, respectively. The 5- and 10-year survival rate of the patients who had received orchiectomy was 53 and 24%, respectively, while that of the patients without orchiectomy was 38 and 14%, respectively. The 5 and 7-year survival rate of the patients treated with intravenous administration of DESP was 54 and 34%, respectively while that of the patients without DESP was 46 and 31%, respectively. These findings suggest that orchiectomy and intravenous administration of DESP in any form prolonged patient survival compared with only oral administration of estrogens or antiandrogens. Reactivation was seen in 24 (40%) of the 60 patients under sufficient observation. Clinical relapse occurred within an average of 32.3 +/- 26.4 months after primary hormonal manipulation. The average time to relapse in stage D was shorter than that in stage B and C. Reactivation was observed in the patients on interrupted treatment earlier than in the patients on continuous administration of drugs. Cardiovascular death followed by endocrine therapy was 7.4% in this study.     

Influence of tumour differentiation on survival after resection for rectal cancer in a series of 1296 patients

The influence of differentiation grade on tumour staging, local recurrence and long term survival prospects has been evaluated in a series of patients managed by resection for rectal cancer. Differentiation was known in 1095 of 1296 patients. Well-differentiated tumours were over-represented among Dukes' stage A cases and poorly differentiated among those with disseminated disease (P less than 0.001). Local recurrence was twice as common (31%) after curative resection of poorly differentiated tumours than of well (14%) or moderately (17%) differentiated. Five year cancer specific survival rates after resection (curative and palliative combined) of tumours of good, average or poor differentiation were 68%, 59% and 33%, respectively. After potentially curative resection, survival was also significantly worse in patients with poorly differentiated tumours (P less than 0.001); 5 year survival rates of patients with tumours of good, average or poor differentiation were 75%, 71% and 51%, respectively. Survival prospects beyond 5 years in patients with Dukes' stage A tumours were significantly reduced when the tumour was poorly differentiated; 5 and 10 year survival rates were 76% and 40%, respectively. However, patients with Dukes' stage C tumours of poor differentiation had an identical 5 and 10 year cancer specific survival, 26%. Patients with mucoid type tumours had worse survival prospects than those with non-mucoid type (P less than 0.02).     

A multimodal treatment of prostatic carcinoma and the 5-year survival rate

One hundred and twenty-nine patients with prostatic carcinoma were treated in our hospital. They were between 49 and 88 (average, 70.3) years old and histological diagnosis was adenocarcinoma in all 129 patients; 42 had well differentiated, 55 moderately differentiated, 31 had poorly differentiated carcinomas, and one undeterminated type. Twenty two patients had stage A carcinoma, 18 stage B, 14 stage C and 75 stage D. As the therapeutic principle no castration was done, radiation therapy was delivered to cases with carcinoma more advanced than stage B in combination with estrogen or alone, and antimetabolites were given to some patients. Cryosurgical procedure to prostate was adjunctively used in patients with dysuria. Since 1986, total prostatectomy was carried out in patients with stage B disease and younger than 60 years old, and total combined resection of the urinary bladder and prostate was performed in patients with more advanced than stage C disease. Etoposide was given to patients with recurrent or metastatic lesions. Twenty-two of the 124 patients who did not receive castration surgery were categorized in stage A, 17 in stage B, 14 in stage C, and 71 in stage D. The 5-year survival rate in each stage group was 100%. 56.2%, 70.0%, and 28.8%, respectively, and the statistical difference between stage A and B, and between stage C and D was respectively significant. The relative 5-year survival rate among the total patient group, 71 patients in stage D, 40 patients in stage D treated with hormone therapy, and 15 patients in stage D treated with radiation therapy was 44.5, 28.7, 18.4 and 36.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of tegafur administration combined with hormonal therapy in patients with newly diagnosed stage D prostatic cancer

To study the effect of tegafur administration combined with hormonal therapy on the survival rate of newly diagnosed patients with stage D prostatic cancer, 66 patients, 70.9 years old in mean age, were treated from 1979 to 1986. The cancer was proven by the histological or cytological examination of the specimen which was obtained by the needle biopsy and/or aspiration biopsy of the prostate. The histopathological diagnosis of 59 patients was as follows: well differentiated type of adenocarcinoma was observed in 13 patients, moderately differentiated type in 19 cases, poorly differentiated type in 24 cases and mixed type in 3 cases. Daily 600 mg tegafur was administered orally as long as possible from the beginning of the treatment combined with hormonal therapy. Actual and relative 5 year survival rates calculated with Kaplan-Meier's method were 31.2% and 39.2%, respectively. When deaths other than prostatic cancer death were counted as lost cases, the actual survival rate was 47.5%. The present study also demonstrated that there were some factors affecting the patients' prognosis. They were the age of onset of the disease (patients under 64 years old were worse than those over 65 years old; p less than 0.05), performance status (patients with PS from 0 to 2 at the first admission were better than those with PS 3 to 4; p less than 0.025), differentiation of the tumor (well differentiated type was better than moderately; p less than 0.025 or poorly differentiated type; p less than 0.005).     

125Iodine implantation for carcinoma of the prostate: 5-year survival free of disease and incidence of local failure

Interstitial implantation with the 125iodine isotope has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. All 7 patients with stage B1 nodules followed to 5 years are free of disease. The actuarial survival free of disease by grade at 5 years was 95 per cent for patients with well, 65 per cent with moderately and 34 per cent with poorly differentiated tumors. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. Patients with positive biopsy plus normal or stable prostatic examinations were not considered local failures, although such patients are at high risk for failure in the future. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with 125iodine isotope is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.     

Clinical study on prostatic cancer patients

Clinical observations on prostatic cancer were studied in 27 patients who had been managed in our department between April, 1980 and December, 1986. The mean age at the time of initial clinical visit was 70.6 years old with a range of 55 to 88 years old. Of all 27 patients, 15 men (55.6%) were senior citizens over 70 years old and indeed 23 men (85.2%) were over 60 years old. According to the general rules for clinical and pathological studies on prostatic cancer, there were 10 patients with stage A, 2 patients with stage B, and 15 patients with stage D disease. However, none of our patients had stage C foci of prostatic cancer. Histopathologically, biopsied or surgically resected specimen all showed adenocarcinoma. More frequently the incidence of poorly differentiated adenocarcinoma was found in the specimen from the patients with advanced clinical disease. Anti-androgen therapy with castration or a combined hormonal manipulation initially was done in 25 patients. Simple hormonal treatment using chlormadinone acetate (CMA) was given in 13 patients. Of 25 patients who received hormone treatment, 22 underwent castration whereas, 12 of 13 having undergone single hormonal therapy were castrated. Combined chemohormonal therapy using UFT and CMA or additionally given estramustine phosphate disodium (Estracyt) was subjected only to stage D disease of prostatic cancer. Of 15 patients surgically treated, 11 received transurethral resection of the prostate on the basis of initial diagnosis of benign prostate hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prostatic cancer in Aust-Agder County, Norway. Age, stage, grade and mode of presentation

Two hundred and five patients (89 per 100,000 men) with newly diagnosed prostatic cancer comprises all cases in the Aust-Agder County in Norway over a 5-year period. There were 36% stage T0 M0, 19% T1-2 M0, 16% T3-4 M0 and 29% T0-4 M1. In patients with well differentiated disease (G1), 8% had distant metastases on presentation, whereas in the moderately differentiated tumors (G2) and the poorly differentiated tumors (G3) distant metastases occurred in 30% and 62%, respectively. A statistically significantly higher proportion of well differentiated (G1) tumors were observed in the younger age groups (less than 70 years). On presentation diagnosis was suspected on routine digital rectal examination in 9% of the patients, while 12% had symptoms on disseminated disease as mode of presentation. Of patients operated upon for apparently benign hyperplasia 13% had prostatic cancer.     

Clinical study of prostate cancer: statistical analysis of 107 cases in the past 12 years

One hundred and seven patients with prostate cancer were treated at Mie University Hospital during the past 12 years between 1988 and 1999. They were between 53 and 83 years old, with an average age of 70.8 years old. The clinical stage was defined as A, B, C and D in 3 (2.8%), 19 (17.8%), 50 (46.7%) and 35 (32.7%) patients, respectively. At initial diagnosis, the tumor was well, moderately and poorly differentiated adenocarcinoma in 26 (24.3%), 47 (43.9%) and 34 (31.8%) patients, respectively. The median follow-up period was 52.3 months. The overall 1, 3 and 5-year survival rates were 98.0%, 86.8% and 75.2%, respectively. The 5-year survival rates for stage A, B, C and D were 100%, 93.8%, 82.1% and 56.9%, respectively. A significant difference (p = 0.017) in 5-year survival rate was noted between stage C and D. The 5-year survival rate was 100% for well differentiated, 78.0% for moderately differentiated, and 53.2% for poorly differentiated adenocarcinoma. A significant difference (p = 0.0016) in the 5-year survival rate was noted between well differentiated and poorly differentiated adenocarcinoma. According to the therapy, the 5-year survival rate in stage C was 86.2% for the radical prostatectomy group and 84.0% for the endocrine therapy group. There was no significant difference between these 2 treatment groups. Endocrine therapies, classified into maximum androgen blockade (MAB) and endocrine therapy other than MAB were performed for stage D as an initial therapy. Although the prognosis in the patients treated with MAB was better than that with other endocrine therapies, there was no significant difference between these 2 endocrine treatment groups.     

Correlation between histologic grading and prognosis of prostatic cancer--comparing the grading system of the Japanese general rules of prostatic cancer with Gleason's grading

To evaluate the correlation between the histological grade and the prognosis, we reviewed 100 cases of prostatic cancer according to the Japanese General Rules of Prostatic Cancer (JGRPC) and Gleason grading system. The study led to the following results: (1) There was a close relation between the JGRPC grade and Gleason score (GS). (2) The JGRPC grade and Gleason score were equally concerned with the clinical stage. (3) There were significant differences in survival rate between well and moderately, well and poorly differentiated groups by the JGRPC grading system, and between GS 2-4 and GS 5-7, GS 2-4 and GS 8-10 groups by Gleason score. (4) In proportion to the JGRPC grade, the cancer death rate increased linearly in each stage. (5) When the patients were grouped according to their JGRPC grades of main lesion and accompanied lesion, the cancer death rate increased in the cases with lower differentiated elements. We conclude that the JGRPC grading system is easily comprehensible, and equal with the Gleason grading system to predict the prognosis of prostatic cancer.     

A pathological study of incidental carcinoma of the prostate. Pathological study of age-groups]

We reviewed 66 patients with stage A adenocarcinoma of the prostate who were treated at our 7 affiliated hospitals in Yokohama between 1984 and 1988. Of 1377 patients who underwent subcapsular prostatectomy (SCP) or transurethral resection of the prostate (TUR-P) for benign prostatic hyperplasia, 66 patients (4.8%) were diagnosed as an incidental carcinoma of the prostate. Of these patients, 36 and 30 were in stage A1 and A2, respectively. In the 66 patients, 59 (4.5%) were detected in 1315 TUR-P and 7 (11.3%) in 62 SCP. Elderly patients over 80 years of age had a higher risk of stage A2 disease. In histological grade, well, moderately and poorly differentiated adenocarcinoma were found in 48 patients (72.7%), 13 (19.7%) and 5 (7.6%), respectively. Among the patients with stage A prostate carcinoma the majority of the age-group less than 79 years old had well differentiated adenocarcinoma. In the age-group more than 80 years old, there were 6 (37.5%) moderately and 2 (12.5%) poorly differentiated tumors. In other words, the age-group more than 80 years old tended to have the moderately or poorly differentiated adenocarcinoma more frequently than those other decades. We expect an increase in the number of patients with stage A2 disease in the future with the expansion of the operative indication, especially in elderly patients.     

Signet-ring-cell carcinoma of the prostate. Electron-microscopic and immunohistochemical studies of eight cases

Primary signet-ring-cell carcinoma of the prostate is extremely rare. We report eight patients with prostatic adenocarcinomas containing significant numbers of signet-ring cells, one of whom presented initially with supraclavicular lymph node metastasis. Patient ages ranged from 50 to 80 years (mean, 67.5). None of the patients had received any form of therapy before biopsy or surgery. All patients presented with advanced disease (five with stage C and three with stage D). All tumors were poorly differentiated adenocarcinomas, M.D. Anderson Hospital system grade IV, Gleason's combined score of 9 or 10. The signet-ring cells were negative for neutral and acid mucins but immunoreactive for prostatic-specific antigen and prostatic acid phosphatase. Ultrastructurally, the signet-ring-cell appearance resulted either from the presence of intracytoplasmic lumina or from vacuoles. Signet-ring cells were also present at the metastatic sites. We conclude that (a) signet-ring-cell carcinoma of the prostate is a variant of poorly differentiated adenocarcinoma of the prostate; and (b) when a metastatic signet-ring-cell carcinoma with negative intracytoplasmic mucin is identified, a prostatic origin should be considered, and prostatic-specific antigen and prostatic acid phosphatase immunostaining should be performed.     

Buserelin treatment of advanced prostatic carcinoma: prognostic factor analysis.

From August 1986 to August 1990, 116 patients with prostatic carcinoma, advanced disease (stage C-D1 only in patients older than 75 years, or D2) were treated with Buserelin (0.5 mg 3 times/day subcutaneously for 7 days, followed by 0.4 mg 3 times/day intranasally) until progression. No concomitant antiandrogens were administered. Of the 108 evaluable patients, 10 had complete remission (CR), 49 partial remission (PR), 46 remained stable while 3 progressed (response rate = 54.6%). Median duration of response was 31 months, median survival was 34 months. The toxicity of treatment was mild and mainly related to the hormonal effect of the drug. Castrate testosterone levels were obtained in all patients except 7. Slight, transient pain increase was noted at day 8 in 12 patients. Absence of symptoms at the start of treatment, well- or moderately differentiated tumor and serum testosterone negativization following Buserelin were associated with a significantly higher response rate as compared to presence of symptoms, poorly differentiated tumor and failure to obtain castrate testosterone levels, respectively. The following prognostic factors were found, at univariate analysis, to be associated with a prolonged survival: stage (C-D1 versus D2), PS (greater than 80 versus equal or less than 80), symptoms (absent versus present) and histological grade (G1 + G2 versus G3). Age and basal T levels did not influence survival. Those patients who obtained a CR or PR survived significantly longer than those with stable disease or progression.(ABSTRACT TRUNCATED AT 250 WORDS)     

Post-irradiation total cystectomy for bladder cancer

Summary Treatment with radiotherapy (6000 rad) followed by total cystectomy was carried out in 125 patients with T1–T3 bladder cancer, the tumour being poorly differentiated (grade III–IV) in 115 cases. Survival was significantly better, if the irradiation had resulted in complete tumour regression before cystectomy, and if the tumour at the initial examination was of category T1. The relative cumulative survival after 5 years for patients with T1-tumours was 60%, as opposed to 40% for patients with T3-tumours. 4 patients (2.4%) died within 30 days of the cystectomy, but 13 patients (10%) died within 3 years from complications of the treatment regime. 83 patients (66%) experienced nonfatal complications such as infected cavity and urinary or intestinal stenosis. 3 years after the cystectomy 62 patients (50%) were dead from recurrent tumour or from other causes.     

Mucoepidermoid carcinoma of the head and neck: A 13-year review

Mucoepidermoid carcinoma (MEC) is a malignant tumour arising from salivary gland tissue. The aim of this study was to review the management of MEC at one institution over a period of 13 years and to identify factors associated with morbidity and mortality. The case notes of patients with MEC treated between 1987 and 2000 were reviewed. Well-differentiated tumours were graded as low grade tumours and poorly differentiated tumours as high grade. Staging was done according to the TMN classification of the American Joint Committee on Cancer (AJCC).The collected data were analysed using GraphPad Prism 4.03. The Kaplan-Meier method and the Logrank Test were used to assess the statistical significance of various groups. There were 37 patients identified. Twenty-one cases were low grade tumours and sixteen high grade. The overall survival rate at 5 and 10 years was 74.8 and 65.2%, respectively. The overall loco-regional control rates at 5 and 10 years were 87.3 and 60.4%, respectively. High grade, high stage and incomplete resection margins had an adverse effect on survival. MEC is best managed in tertiary centres where the patients can be assessed and treated by a multidisciplinary team.     

Clinical investigation of prostate carcinoma in the Third Teaching Hospital of Norman Bethune University of Medical Sciences

Clinical and statistical investigations were performed on 157 patients with prostate carcinoma in the Third Teaching Hospital, Normal Bethune University experienced between January, 1950 and June, 1986. The number of patients with prostate carcinoma among other hospitalized patients showed a recent gradual increase. The patient's age at the time the disease was first diagnosed was most frequently between 60 and 69 years old with an average age of 63.3 years. Dysuria was the most prominent symptom, followed by frequency, retention and macroscopic hematuria. Duration between initial symptom and diagnosis was one to two years in most patients. The prostatic abnormality could be detected by rectal examination in all patients. Elevation of serum acid phosphatase was found in 24.4%. Such elevation was evident in 52.2% of the patients with metastatic lesions, compared to 14.4% of those without metastasis. Fourteen patients had metastasis to bone (8.9%), 13 to lymph nodes, 2 to lung and one to liver. According to the staging diagnosis, 19 patients (12.1%) had stage A, 78 patients (49.7%) had stage B, 20 patients (12.7%) had stage C and 40 patients (25.5%) had stage D carcinoma. Histological findings in 57 patients indicated adenocarcinomas; 39 cases (68.4%) were poorly differentiated, 12 cases (21.2%) were moderately differentiated and 6 cases (10.5%) were well differentiated. Modality of treatment was total prostatectomy in 2 cases (1.3%), antiandrogen therapy (orchiectomy and/or Stilbestrol) in 122 cases (77.7%), subcapsular prostatectomy in 7 cases (4.5%), symptomatic treatment in 5 cases and no treatment in 23 cases (14.6%).