Prostate cancer in men aged less than 50 years at diagnosis

Kinnear, Ned; Kichenadasse, Ganessan; Plagakis, Sophie; O’Callaghan, Michael; Kopsaftis, Tina; Walsh, Scott; Foreman, Darren

doi:10.1007/s00345-016-1824-4

Cited by 17 publications

(29 citation statements)

References 24 publications

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“…A 60-year-old patient with a low risk and Gleason score 6 PCa is a suitable candidate for active surveillance. However, a similar scenario in men aged 45–55 might prompt immediate intervention in majority of cases, because of opinion that PCa detected in young age might behave more aggressively [7] and because young men are more likely to undergo RP [8]. Data about young age men with PCa treatment outcomes are controversial.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Oncological Outcomes for Young Men Undergoing Radical Prostatectomy for Localized Prostate Cancer

Milonas

Venclovas

Gudinavičienė

et al. 2017

BioMed Research International

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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.

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Section: Introductionmentioning

confidence: 99%

Long-Term Oncological Outcomes for Young Men Undergoing Radical Prostatectomy for Localized Prostate Cancer

Milonas

Venclovas

Gudinavičienė

et al. 2017

BioMed Research International

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“…The aggressiveness of PCa in young patients is still a subject of debate, with opposite and contrasting results in different publications [24,25]. For these reasons, we cannot definitely establish the role that age plays in the pathogenesis of PCa.…”

Section: Discussionmentioning

confidence: 92%

Multiparametric Magnetic-Resonance to Confirm Eligibility to an Active Surveillance Program for Low-Risk Prostate Cancer: Intermediate Time Results of a Third Referral High Volume Centre Active Surveillance Protocol

et al. 2018

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Background: To evaluate the role of confirmatory multiparametric magnetic resonance imaging (mpMRI) of the prostate at the time of Active Surveillance (AS) enrollment to reduce disease misclassification. Materials: From 2012 to 2016, 383 patients with low-risk disease respecting Prostate Cancer Research International AS criteria underwent confirmatory 1.5-T mpMRI. AS was proposed to patients with Prostate Imaging and Report and Data System (PI-RADS) score ≤3 and no extraprostatic extension (EPE), whereas patients with PI-RADS score ≥4 and/or EPE were treated actively. Kaplan-Meier analyses quantified progression-free survival (PFS) in patients enrolled in the AS program. Logistic regression analyses tested the association between confirmatory mpMRI and clinically significant prostate cancer (csPCa) at radical prostatectomy (RP). Diagnostic performance of mpMRI was calculated in patients submitted to immediate RP. Results: PFS rate was 99, 90 and 86% at 1, 2 and 3 years respectively. At multivariable analysis, PI-RADS 3, PI-RADS 4, PI-RADS 5 and EPE increased the probability of having csPCa at immediate RP (PI-RADS 3 [OR] 1.2, p = 0.26; PI-RADS 4 [OR] 5.1, p = 0.02; PI-RADS 5 [OR] 6.7; p = 0.009; EPE [OR] 11.8, p < 0.001). Confirmatory mpMRI showed sensibility, specificity, positive predictive value and negative predictive value of 85, 55, 68 and 76% respectively. Conclusions: MpMRI at the time of AS enrollment reduces the misclassification rate of csPCa. We suggest to perform target biopsies in patients with PI-RADS score 3 and 4 lesions.

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“…Since the publications of the reviews on this topic in 2014 by Hussein et al 20 and in 2015 by Salinas et al 21 , 13 more studies discussing the impact of younger age on the PCa clinicopathological features or outcome prognosis in younger patients were published. In these studies, 2 of 2 studies with multivariate analyses showed similar BCR-free survival between younger and older patient groups, 25,33 but 2 of the 5 articles 12,15 showed younger age was an independent predictor for better BCR prognosis in the studies published before 2015.…”

Section: Discussionmentioning

confidence: 97%

“…After excluding case reports, non-published materials, editorials, reviews, commentaries, conference abstracts, and animal experiments, as well as irrelevant-topic studies with the first browse of title and abstract, the full-text of 191 papers, were read in detail to determine the eligibility. Finally, a total of 26 studies published from 2000 to 2019 with 391 068 patients in PSA era were included in the current study ( Table 1, Stable 1), 12,15,18,19,[22][23][24][25][26][27][28][29][30][31][32][33][34][39][40][41][42][43][44][45][46][47] and the majority of these studies were of relatively high quality with seven or more stars according to the NOS assessment ( Table 1). Seven out of the 26 studies which provided the data on comparing clinicopathological characteristics between younger (age ≤ 50) and older (age > 50) patients were suitable for odds ratio (OR) meta-analyses (Table 2).…”

Section: Literature Searchmentioning

confidence: 99%

“…Since the publication of these reviews, more work regarding clinicopathologic characteristics of younger patients and the impact of early screening prognosis of PCa after RP have been reported. [22][23][24][25][26][27][28][29][30][31][32][33][34] In recent years, to avoid the overtreatment of indolent low-risk PCa detected by PSA screening, active surveillance (AS) treatment option has been increasingly adopted. 35 When the safety and feasibility of AS on younger patients were investigated by Salari et al, 36 they reported that AS outcome for men aged ≤ 60 years was similar to those patients at an age older than 60 years.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological characteristics of localized prostate cancer in younger men aged ≤ 50 years treated with radical prostatectomy in the PSA era: A systematic review and meta‐analysis

Zheng

Lin

et al. 2020

Cancer Medicine

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Objectives With the rapid increase in younger age prostate cancer (PCa) patients, the impact of younger age on decision‐making for PCa treatment needs to be revaluated in the new era. Materials and Methods A systematic literature search was performed using PubMed, EMBASE, and Web of Science up to October 2019 to identify the eligible radical prostatectomy (RP) studies focusing on understanding the impact of age on clinicopathological features and oncological prognosis in patients with localized PCa in PSA era. Meta‐analyses were conducted using available hazard ratios (HRs) from both univariate and multivariate analyses. Results Twenty‐six studies including 391 068 patients with RP treatments from the PSA era were included. Of these studies, age of 50 years old (age50) is the most commonly used cut‐off age to separate the younger patient group (including either age < 50 or age ≤ 50) from the older patient group. In these studies, the incidence of younger patients varied between 2.6% and 16.6% with a median of 8.3%. Younger patients consistently showed more favorable clinicopathological features correlated with better BCR prognosis. Meta‐analyses showed a 1.38‐fold improved BCR survival of younger patients in multivariate analysis. Among the high‐risk PCa patients, younger age was independently associated with worse oncological outcomes in multivariate analyses. Conclusion In this study, we found younger age correlated with favorable clinicopathological characteristics and better BCR prognosis in low‐ to intermediate‐risk patients. In high‐risk group patients, younger patients often showed significantly worse oncological outcomes. Our study results suggest that age 50 could be used as a practical cut‐off age to separate younger age patients from older age PCa patients.

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Prostate cancer in men aged less than 50 years at diagnosis

Cited by 17 publications

References 24 publications

Long-Term Oncological Outcomes for Young Men Undergoing Radical Prostatectomy for Localized Prostate Cancer

Long-Term Oncological Outcomes for Young Men Undergoing Radical Prostatectomy for Localized Prostate Cancer

Multiparametric Magnetic-Resonance to Confirm Eligibility to an Active Surveillance Program for Low-Risk Prostate Cancer: Intermediate Time Results of a Third Referral High Volume Centre Active Surveillance Protocol

Clinicopathological characteristics of localized prostate cancer in younger men aged ≤ 50 years treated with radical prostatectomy in the PSA era: A systematic review and meta‐analysis

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