UroToday - Progression After Radical Prostatectomy for Men in their Thirties Compared to Older Men - Abstract

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Wednesday, 26 March 2008

Buchanan Brady Urological Institute, s Hopkins Medical

Institutions, Baltimore, MD, USA.

To assess the biochemical outcome after radical prostatectomy (RP)

specifically for men aged 30-39 years, as previous studies suggest that

prostate cancer in young men might be more aggressive.

From a large (15 899) database of RPs (1975-2007) we identified 42 men aged

30-39, 893 aged 40-49, 4085 aged 50-59, 3766 aged 60-69, and 182 men aged

>/=70 years old. The clinical characteristics and treatment outcomes were

compared between men aged 30-39 years and older men.

Among the men in their thirties, 81% had organ-confined disease in the RP

specimen, vs 62% of men aged >/=40 years. At a mean follow-up of 5 years,

there was biochemical progression in 4.8% of men in their thirties and 16.1%

of men age >/=40 years (P = 0.055). The corresponding 5-year biochemical

progression-free survival estimates were 95% for men in their thirties and

83% for men aged >/=40 years (P = 0.045). On multivariate analysis,

increasing age was a significant independent predictor of biochemical

progression.

Contrary to earlier reports, in the present study men in their thirties did

not have more aggressive disease. Instead, they had more favourable

pathological features and progression-free survival rates than their older

counterparts. After controlling for other prognostic variables on

multivariate analysis, being in the fourth decade was independently

associated with a lower risk of biochemical progression. These results

suggest that early aggressive treatment for these patients with a long

life-expectancy is associated with favourable long-term biochemical

outcomes.

Written by

Loeb S, DJ, Mangold LA, Humphreys EB, Agro M, Walsh PC, Partin AW,

Han M.

Reference

BJU Int. 2008 Mar 13. Epub ahead of print.

doi:10.1111/j.1464-410X.2008.07500.x

PubMed Abstract

PMID:18341626