Epidemiology and Survival Outcomes of Genitourinary  Cancers: A Retrospective Cohort Study from Southern Saudi  Arabia

Ahmed M. Badheeb; Omar Alkhanbashi; Qasim Alzubaidi; Abdullah Al Asmari; Doaa Abdallah Eltohami; Faisal Ahmed; Esam Ali Ben Yahya; Samer Alkarak; Omar S. Baslasel; Abdelaziz Aman; Islam Seada; Abdullah Abubakar; Mohamed A. Badheeb

doi:10.31557/apjcc.2025.10.4.1149-1156

Authors

Ahmed M. Badheeb Oncology, King Khalid Hospital, Najran, Saudi Arabia. Department of Oncology, Faculty of Medicine, Hadhramout University, Mukalla, Yemen.
Omar Alkhanbashi Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Qasim Alzubaidi Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Abdullah Al Asmari Internal Medicine, King Khalid Hospital, Najran, Saudi Arabia.
Doaa Abdallah Eltohami Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Faisal Ahmed Department of Oncology, Faculty of Medicine, Hadhramout University, Mukalla, Yemen.
Esam Ali Ben Yahya Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Samer Alkarak Cardiothoracic Surgery, King Khalid Hospital, Najran, Saudi Arabia.
Omar S. Baslasel Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Abdelaziz Aman Department of Urology, Faculty of Medicine, Ibb University, Ibb, YEM.
Islam Seada Internal Medicine/Endocrine and Diabetes, King Khalid Hospital, Najran, Saudi Arabia.
Abdullah Abubakar Department of Ophthalmology, King Khalid Hospital, Najran, Saudi Arabia.
Mohamed A. Badheeb Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, USA.

DOI:

https://doi.org/10.31557/apjcc.2025.10.4.1149-1156

Keywords:

Genitourinary Neoplasms, Prostate Cancer; Bladder Cancer, Renal Cell Carcinoma, Testicular Cancer, Survival Analysis, Saudi Arabia, Cancer Epidemiology, Prognostic Factors, Surgical Oncology

Abstract

Background: Genitourinary (GU) cancers represent a significant health burden in Saudi Arabia, yet region-specific data from the southern Najran region are scarce. This study aims to characterize the epidemiology and survival outcomes of GU malignancies in this understudied population.

Patients and Methods: We conducted a retrospective single-center cohort study of 150 adults with histologically confirmed GU cancers (prostate [38.0%], bladder [28.7%], renal cell carcinoma [26.0%], testicular [7.3%]) treated at King Khaled Hospital, Najran, between 2014 and 2023. Demographic, clinical, and treatment data were analyzed. Overall survival (OS) was assessed using Kaplan-Meier methods. Multivariable Cox regression and propensity score matching were used to identify prognostic factors.

Results: The cohort was predominantly male (85.3%) with a mean age of 64.2 years. At diagnosis, 42.0% had localized disease, 18.0% had regional involvement, and 40.0% had metastatic disease. With a median follow-up of 42 months, 98 deaths were observed. The median OS for the entire cohort was 28.4 months (95% CI: 24.1–32.7). The 5-year OS rates varied significantly by subtype: prostate, 38.5%; bladder, 47.2%; renal cell carcinoma, 51.8%; and testicular cancer, 89.3%. Multivariable analysis identified metastatic disease (adjusted hazard ratio [aHR] = 3.85; 95% CI: 2.91–5.10) and increasing age (per decade, aHR = 1.42; 95% CI: 1.21–1.67) as independent predictors of mortality. Surgical treatment was associated with a significant survival benefit (aHR = 0.52; 95% CI: 0.40–0.68), a finding confirmed in a propensity-matched analysis.

Conclusions: This first comprehensive analysis from Najran reveals a high burden of advanced GU cancers and significant survival disparities. Metastatic disease and older age are key drivers of mortality, while surgical intervention is strongly associated with improved outcomes. These findings underscore an urgent need for enhanced early detection programs and optimized treatment access in this region.