Introduction and Objectives Metastatic hormone‐sensitive prostate cancer (mHSPC) accounts for 12% of prostate cancers diagnosed in Guadeloupe according to the Guadeloupean cancer registry. Most published studies have been conducted on the Caucasian population, whereas data concerning mHSPC in the Afro‐Caribbean population are lacking. We aimed to describe the patient characteristics and estimate the progression‐free survival of men with mHSPC in an Afro‐Caribbean population according to the available treatment. Patients and Methods This was a monocentric retrospective study that consecutively included 133 men with mHSPC between January 1, 2015 and December 31, 2019 at the University Hospital of Guadeloupe. The primary endpoint was a description of the patients' characteristics with a description of complications at diagnosis. The secondary endpoint was progression‐free survival. Kaplan–Meier survival and Cox proportional hazard analyses were performed. Results The median age at diagnosis was 71 years. The median prostate‐specific antigen (PSA) was 147 ng/ml and 37% of patients presented with a disease‐related complication at diagnosis. The survival analysis according to treatment showed median survival of 15 months for the androgen deprivation therapy (ADT) + chemotherapy group, 20 months for the ADT + new hormone therapy group, and 21.5 months for the ADT alone group, with no significant difference between the three therapeutic options (log‐rank test: 0.27). In univariate analysis, none of the patient characteristics at diagnosis (i.e., age, PSA, bone lesions, visceral lesions) were significantly associated with the risk of progression, regardless of the treatment. Conclusion There was no significant difference in terms of progression‐free survival between currently validated treatments administered in the first line, regardless of the tumor volume or risk group. Future studies with larger numbers of patients and involving molecular factors are required to confirm or invalidate these results and understand the evolution of prostate cancer in our population and thus better prevent complications related to the disease.

and had persistent elevated prostate-specific antigen. Post-operative imaging and management strategies were collated. Probability of metastasis-free survival (MFS), prostate cancer specific survival (CSS) and overall survival (OS) among this cohort of men using Kaplan-Meier methods.RESULTS: We identified 258 patients meeting the elgibility criteria, of which 128 patients developed metastasis. The 5-year and 10-year MFS probability was 52% (95% CI 45%, 58%) and 38% (95% CI 29%, 47%), respectively. We identified 58 patients who died of any cause, 48 from disease. The 5 and 10-year survival probabilities from disease are 89% (95% CI 84%, 93%), and 68% (95% CI 58%, 76%), respectively; and from any cause are 87% (95% CI 81%, 91%), and 63% (95% CI 53%, 71%), respectively. Postoperative imaging was obtained for 77% of patients, of whom 87% had a negative scan. Post-operative treatment included hormonal deprivation in 88% of men, observation alone in 7%, adjuvant radiotherapy in 4%, and combined chemotherapy and hormonal therapy in 1%.CONCLUSIONS: In the absence of clear pre-existing data or guidelines, we highlight our experience of patients with nodal invasion and PSA persistence post-prostatectomy. We highlight compromised metastatases-free survival and overall survival. Further, we highlight the limited role for conventional imaging in this cohort.