Progression Outcomes After Radical Prostatectomy For Men In Their 30's Compared To Older Men

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 21 Jun 2008 - 8:00 PDT

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ORLANDO, FL (UroToday.com) - Previous studies have suggested that prostate cancer in young men may behave more aggressively. These reports have recently been refuted. There remains a scarcity of data on the biochemical outcome after radical prostatectomy specifically for men in their 30's.

These investigators from Johns Hopkins used a large (n=15,899) radical prostatectomy database (1975-2007) to identify 42 men aged 30-39, 893 aged 40-49, 4,085 aged 50-59, 3,766 aged 60-69, and 182 men >70years old. The clinical characteristics and treatment outcomes were compared between men in their 30's and older men.

Among the men in their 30's, 81% had organ-confined disease in the radical prostatectomy specimen, compared to 62% of men aged 40 or older. At a mean follow-up of 5 years, biochemical progression occurred in 4.8% of men in their 30's 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 30's, and 83% for men >40 years old (p=0.045). On multivariate analysis, increasing age was a significant independent predictor of biochemical progression.

They conclude that contrary to earlier reports, in this surgical population men in their 30's did not have more aggressive disease. Instead, they had more favorable pathological features and progression-free survival rates than their older counterparts. After controlling for other prognostic variables on multivariate analysis, age in the 30's 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 favorable long-term biochemical outcomes.

Presented by Stacy Loeb, MD, David J Hernandez, MD, Leslie A Mangold, MD, Elizabeth B Humphreys, MD, Marilyn Agro, MD, Patrick C Walsh, MD, Alan W Partin, MD, Misop Han, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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