Determinants of time to death among prostate cancer patients at Uganda cancer institute. A survival regression analysis

Abstract

The study sought to examine the determinants of time to death among prostate cancer patients following diagnosis at the Uganda Cancer Institute. A retrospective cohort design was employed, involving 433 patients diagnosed with prostate cancer between January 1, 2015, and December 31, 2016, who were subsequently followed for five years. Kaplan–Meier estimates were used to determine the median survival time, while the log-rank chi-square test was applied at the bivariate level to assess differences in survival across categorical variables. A multivariate Cox proportional hazards model was fitted to identify the socio-demographic and clinical factors influencing survival outcomes among prostate cancer patients. The results revealed a median survival time of 19 months (95% CI: 14,23) following diagnosis, with patients’ ages ranging from 45 to 90 years (median = 70 years). Out of the 433 patients, 264 (60.9%) died within five years. Multivariate Cox regression analysis showed that advanced age at diagnosis was significantly associated with a higher risk of death (HR = 1.04; 95% CI: 1.03,1.06; p -value = 0.000). Similarly, patients diagnosed with bone metastasis (HR = 1.32; 95% CI: 1.03,1.70; p-value = 0.030) and those with a Gleason score of 8 or higher (HR = 1.93; 95% CI: 1.23,3.02; p-value = 0.004) had significantly shorter survival times compared to their counterparts. These findings indicate that survival among prostate cancer patients at the Uganda Cancer Institute remains low, with advanced age, presence of bone metastasis, and high Gleason score as key prognostic factors. The results reinforce the need to strengthen early detection and screening programs and to enhance regular clinical monitoring, particularly for older patients and those with high-risk disease profiles. Subject Keywords; Death, Prostate cancer patients, Uganda cancer institute.