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Title: Prostate cancer in men aged less than 50 years at diagnosis
Austin Authors: Kinnear, Ned J;Kichenadasse, G;Plagakis, S;O'Callaghan, M E;Kopsaftis, T;Walsh, S;Foreman, D
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Royal Adelaide Hospital, Adelaide, South Australia, Australia
Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia
South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, South Australia, Australia
Flinders University, Adelaide, South Australia, Australia
Urology Unit, Repatriation General Hospital, SA Health, Adelaide, South Australia, Australia
University of Adelaide, Adelaide, South Australia, Australia
Issue Date: Nov-2016 2016-04-12
Publication information: World Journal of Urology 2016; 34(11): 1533-1539
Abstract: PURPOSE: Prostate cancer (CaP) in younger men (age ≤50 years) appears to present differently compared with older men. This study describes CaP characteristics and outcomes in Australian young men. METHODS: The South Australian Prostate Cancer Clinical Outcomes Collaborative database was used to identify men diagnosed with CaP 1998-2012. Men were stratified by age at diagnosis into groups ≤50, 50-70 and ≥70 years. Primary outcomes of cumulative biochemical recurrence (BCR) and cumulative prostate cancer-specific mortality (PCSM) were assessed at 5 and 10 years. RESULTS: In total, 7018 men were included. At time of diagnosis, 182 (2.6 %) were aged ≤50 years. Median follow-up exceeded 4 years. Younger men had a greater proportion of T stage <2 disease, lower median PSA and higher rates of Gleason score <7 (all p < 0.001). They were more likely to experience active surveillance (AS) (4.9, 3.1, 1.5 %) or radical prostatectomy (RP) (70, 55, 8 %) and less likely radiotherapy (13, 24, 29 %) as their principal modality (all p < 0.001). Although only 4.9 % underwent AS, 48 % of men ≤50 years were eligible for AS. Men ≤50 years had both the lowest unadjusted cumulative BCR and PCSM at 10 years. After multivariate analysis, BCR was not significantly different. Sample size limited multivariate analysis of PCSM. CONCLUSIONS: In our cohort, men ≤50 years with CaP had less aggressive clinical characteristics, but were more likely to undergo RP. They appear to experience lower unadjusted PCSM, but similar rates of adjusted BCR. Further studies are needed to assess whether AS is appropriately utilised in these men.
DOI: 10.1007/s00345-016-1824-4
PubMed URL:
Type: Journal Article
Subjects: Biochemical recurrence
Prostate cancer
Young men
Appears in Collections:Journal articles

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