Abstract
Aim. The aim of this study was to describe PCa characteristics and long-term outcomes in young men aged ≤55 years after radical prostatectomy (RP) and to compare them with older men cohort. Methods. Among 2,200 patients who underwent RP for clinically localized PCa at our centre between 2001 and 2015, 277 (10.3%) men aged ≤55 years were identified. All preoperative and pathological parameters were compared between groups. Biochemical progression free survival (BPFS) and disease progression free survival (DPFS) were assessed at 5 and 10 years. Results. Men aged ≤55 years had similar pathological tumor characteristics and biochemical recurrence rate (BCR) compared to their older counterparts. Disease progression rate 2.5% versus 0.4% was higher in older patients (p = 0.026). BPFS rate was not different in both study groups. Estimated 10-year DPFS was 98.8% in younger men compared to 89.2% in their older counterparts (p = 0.031). Multivariate Cox regression showed that Gleason score lymph-nodes and surgical margins status were significant predictors for disease progression. Conclusions. In our cohort, men aged ≤55 years had similar pathological PCa characteristics and BCR rate in comparison with older men. RP can be performed with excellent long-term DPFS results in men with localized PCa at ≤55 years of age.
Highlights
Prostate cancer (PCa) is a disease of the elderly with 80% of men diagnosed at the age ≥65 [1]
Within presented study cohort (Table 1), younger men aged ≤55 years were more likely to present with low prostate specific antigen (PSA) level (p = 0.038), clinically organ confined disease (p < 0.001), and less aggressive tumor according to biopsy Gleason score (p = 0.046)
biochemical recurrence rate (BCR) was similar between groups and reached 29% during median 50 months overall follow-up; metastases were detected at significantly higher rate in older men (p = 0.026)
Summary
Prostate cancer (PCa) is a disease of the elderly with 80% of men diagnosed at the age ≥65 [1]. Different autopsy studies show high rates of latent PCa in the fourth and fifth decades of age. The prevalence of latent PCa in younger men varies markedly among different autopsy series from 2.6% in Greek series [3] to a much higher 27% prevalence in Hungary [4] and up to 34% in USA [5]. The study shows that about 20%–30% of 40–50-year-old men would harbor a PCa [6]. Data about young age men with PCa treatment outcomes are controversial. According to the pre-PSA era studies, younger men are likely to have a more aggressive disease and carry a worse prognosis [9, 10]. More recent studies suggest high rates of indolent PCa with more favorable outcomes in young men after radical prostatectomy (RP) compared to their older counterparts
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