Evaluation of the Positive Response Rate to First-Generation Hormone Therapy (FGHT) in Patients with Prostate Cancer (PCa) in Kinshasa, from January 2014 to January 2025

Abstract

Introduction: Prostate cancer (PCa) is a hormone-dependent malignancy and a major public health concern. In resource-limited settings such as the Democratic Republic of the Congo, it is frequently diagnosed at an advanced stage, making hormone therapy the cornerstone of management. Objective: To evaluate the rate of positive response to FGHT and to determine the time to castration resistance (CR) and associated factors. Methods: We conducted a retrospective observational cohort study including 258 patients with PCa treated at the Pointe-à-Pitre Clinic (CPAP) in Kinshasa between January 2014 and January 2025. Results: The mean age was 70.7 years (range: 53 - 94). Most patients presented with advanced, high-risk or metastatic disease (94.6%). A positive response to FGHT was observed in 82.1% of patients. An initial PSA ≥100 ng/mL, the elevated SGOT levels (≥38 U/L), the presence of metastases at diagnosis, the high ISUP grade (3 - 5), advanced tumor stage (cT3 - cT4), and high or very high risk classification according to D’Amico/NCCN/STAMPEDE were several factors significantly associated with the development of CR. The median time to CR, estimated by Kapan-Meier analysis, was 18 months. The median overall survival was 28 months. The overall mortality rate was 15.8%. Conclusion: In our setting, PCa predominantly affects men aged 70 - 79 years and is most often diagnosed at an advanced stage. FGHT shows substantial efficacy, with a high rate of positive response. CR develops progressively, allowing many patients to remain hormone-sensitive after five years. FGHT therefore remains a valuable therapeutic option in resource-limited settings.