Variant Histology and Clinicopathologic Features of Prostate Cancer in Men Aged <50 Years Treated with Radical Prostatectomy

While prostate cancer (PCa) is primarily a disease of older men, young-age PCa represents an important clinical subgroup which has not been adequately studied. We evaluated the histopathological features and associated clinical behavior of PCa in a cohort of younger men treated with radical prostatectomy (RP).

The study included 171 men aged <50 years with PCa treated with RP at an academic institution between 2001-2015. Comprehensive pathology review was performed. Clinical and follow-up data was obtained from a prospectively maintained institutional database.

Median age was 43 years (range 38-49). The majority of tumors were Gleason score(GS) 3+3 (42%) or GS3+4 (45%), while GS4+3, GS4+4 and GS4+5 comprised 10.5%, 0.5% and 1% of cases, respectively. Mucinous carcinoma (>25% extracellular mucin), an uncommon histologic variant which comprises 0.2% of PCa, constituted 6% (n=11) of our cases. Additionally, a further 21 cases (12%) of acinar adenocarcinoma had a mucinous (<25%) component. Follow-up data was available for 156 men (91%): biochemical recurrence occurred in 12 patients (19%) while there was no documented post-operative metastasis or death from disease in the cohort. All cases of mucinous carcinoma were associated with favorable clinicopathologic characteristics.

Our findings provide additional evidence that younger men with PCa treated with RP mostly have favorable disease characteristics and outcomes. While the histopathologic features in our series were generally comparable to older onset carcinoma, our cohort was enriched for tumors with a mucinous phenotype. Correlation with molecular-genetic analysis in this subset of tumors may be valuable.

The Journal of urology. 2017 Jan 24 [Epub ahead of print]

Susan Prendeville, Michael E Nesbitt, Andrew J Evans, Neil E Fleshner, Theodorus H van der Kwast

Department of Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Division of Urology, Department of Surgery, University Health Network, Toronto, Ontario, Canada. Electronic address: ., Department of Pathology, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Division of Urology, Department of Surgery, University Health Network, Toronto, Ontario, Canada.

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