In this study, the authors focus on younger men (age < 55) diagnosed with prostate cancer to identify how they differ from their older counterparts. Specifically, they focused on the outcomes of men younger than 55 undergoing radical prostatectomy. Data was obtained from the Victorian Cancer registry, encompassing all patients with cancer diagnosis from 2004 to 2014. In that time period, 109 were between 35 and 44 while 1,998 were between age 45 and 54. They were then compared against men between ages 55 and 74.
On univariate analysis, men under age 55 had higher rates of Gleason<= 7 disease and <= cT2 disease, while having similar median PSA values at the time of diagnosis. On MV analysis, adjusting for Gleason grade, T-stage and PSA, men between 45-54 had an improved overall survival, but this difference was not seen in men age 35-44. The 5- and10-year OS was higher for men 45-54 than men age 55-74. Unfortunately, the MV analysis was not listed, so these results could not be verified.
However, in terms of events and 5- and 10-year CSS, younger men had much fewer events and much better CSS.
There are many questions that need to be addressed. First, what was the median follow-up? Young patients are unlikely to die of other causes in that same time frame – hence OS may not be a very good outcome to measure. Additionally, much younger patients developing prostate cancer may have some genetic predisposition that was never assessed for – those patients may affect the survival outcomes. Stage-matched survival also would have been more useful to present.
While important to understand, further analysis needs to be done to tease out the difference.
Speaker(s): Luke Wang, Australia
Institution(s): Eastern Health, Australia
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal