Raisa S Pompe1,2, Ariane Smith3,4, Marco Bandini3,5, Michele Marchioni3,6, Tristan Martel3,4, Felix Preisser7, Sami-Ramzi Leyh-Bannurah7,3,8, Jonas Schiffmann9, Fred Saad3,4, Hartwig Huland7, Markus Graefen7, Shahrokh F Shariat10, Derya Tilki3,8, Pierre I Karakiewicz3,4. 1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. rapompe@gmail.com. 2. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada. rapompe@gmail.com. 3. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada. 4. Department of Urology, University of Montreal Health Center, Montreal, QC, Canada. 5. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 6. Department of Urology, SS Annunziata Hospital, "G.D'Annunzio" University of Chieti, Chieti, Italy. 7. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 8. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 9. Department of Urology, Academic Hospital Braunschweig, Braunschweig, Germany. 10. Department of Urology, University of Vienna, Vienna, Austria.
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.
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.
Authors: Derya Tilki; Valentin Maurer; Raisa S Pompe; Felix K Chun; Felix Preisser; Alexander Haese; Markus Graefen; Hartwig Huland; Philipp Mandel Journal: World J Urol Date: 2019-04-02 Impact factor: 4.226
Authors: Mun Su Chung; Myungsun Shim; Jin Seon Cho; Woojin Bang; Sun Il Kim; Sung Yong Cho; Koon Ho Rha; Sung Joon Hong; Kyo Chul Koo; Kwang Suk Lee; Byung Ha Chung; Seung Hwan Lee Journal: J Korean Med Sci Date: 2019-03-06 Impact factor: 2.153
Authors: Yu Zheng; Sharron X Lin; Shulin Wu; Douglas M Dahl; Michael L Blute; Wei-De Zhong; Xing Zhou; Chin-Lee Wu Journal: Cancer Med Date: 2020-07-22 Impact factor: 4.452