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Tumor characteristics, treatments, and oncological outcomes of prostate cancer in men aged ≤50 years: a population-based study

Prostate Cancer and Prostatic Diseases volume 21, pages 71–77 (2018)Cite this article

Subjects

Abstract

Background

To examine clinical characteristics, treatment modalities and oncological outcomes of prostate cancer (PCa) according to young (≤50) vs. old age.

Methods

Of 407,599 men with primary adenocarcinoma of the prostate within the Surveillance, Epidemiology and End Results (SEER)-database (2004 to 2013), 18,387 were aged ≤50 years (4.5%). Time trends, cumulative incidence, and competing risks regression (CRR) analyses tested for differences between young and old patients. Multi-variable analyses were adjusted for year of diagnosis, race, marital status, Gleason Score, clinical tumor stage, and lymph node status.

Results

Younger men had more favorable tumor characteristics: lower Gleason Score, lower median PSA, and lower rates of metastases at diagnosis compared to their older counterparts. Over time, no local treatment (NLT) rates increased, radical prostatectomy (RP), and brachytherapy (BT) rates decreased and external beam radiation (EBRT) rates remained unchanged. Moreover, the rate of de novo metastatic prostate cancer increased in young patients from 2% (2004) to 3.2% (2013) (p = 0.004). CRR models showed no difference in prostate cancer-specific mortality (PCSM) between young and old, across all local treatment types.

Conclusions

Young PCa patients have more favorable disease characteristics at presentation, are less frequently treated with RP or BT and more frequently benefit of NLT. PCSM did not differ between young and old patients. However, it is worrisome that recently more young PCa patients are diagnosed at a metastatic stage.

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Authors and Affiliations

  1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Raisa S. Pompe, Felix Preisser, Sami-Ramzi Leyh-Bannurah, Hartwig Huland & Markus Graefen

  2. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada

    Raisa S. Pompe, Ariane Smith, Marco Bandini, Michele Marchioni, Tristan Martel, Sami-Ramzi Leyh-Bannurah, Fred Saad, Derya Tilki & Pierre I. Karakiewicz

  3. Department of Urology, University of Montreal Health Center, Montreal, QC, Canada

    Ariane Smith, Tristan Martel, Fred Saad & Pierre I. Karakiewicz

  4. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Marco Bandini

  5. Department of Urology, SS Annunziata Hospital, “G.D’Annunzio” University of Chieti, Chieti, Italy

    Michele Marchioni

  6. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Sami-Ramzi Leyh-Bannurah & Derya Tilki

  7. Department of Urology, Academic Hospital Braunschweig, Braunschweig, Germany

    Jonas Schiffmann

  8. Department of Urology, University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

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  1. Raisa S. Pompe
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  2. Ariane Smith
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  9. Fred Saad
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Corresponding author

Correspondence to Raisa S. Pompe.

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The authors declare that they have no competing interests.

Additional information

Raisa S. Pompe and Ariane Smith contributed equally to this work

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Pompe, R.S., Smith, A., Bandini, M. et al. Tumor characteristics, treatments, and oncological outcomes of prostate cancer in men aged ≤50 years: a population-based study. Prostate Cancer Prostatic Dis 21, 71–77 (2018). https://doi.org/10.1038/s41391-017-0006-9

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