Survival outcomes of younger men (< 55 years) undergoing radical prostatectomy.

Abstract

The aim of the paper is to investigate the outcomes of patients younger than 55 years in Victoria, Australia undergoing radical prostatectomy (RP) for prostate cancer. Data on all men undergoing RP in Victoria between January 1, 2004 and December 31, 2014 were obtained from the Victorian Cancer Registry. Tumor characteristics including Gleason grade, stage of disease (based on final pathology specimen), and cause of death were also obtained. Statistical analysis was performed using Chi-square test, Cox proportional hazards method, and Kaplan-Meier analysis. A total of 14,686 men underwent RP during the defined period. Of these men 109 were aged 35-44 years and 1,998 were aged 45-54 years. Men aged 35-44 years and 45-54 years were compared against men aged 55-74 years. The majority of men between the ages of 35 years and 44 years, and 45 years and 54 years had higher rates of Gleason ≤ 7 disease compared with men aged between 55 years and 74 years (92.7% vs. 86.8% vs. 79.3%;P < 0.01) and ≤ T2 disease (82.6% vs. 75.6% vs. 49.9%;P < 0.01) but similar median prostate-specific antigen values. On a multivariate analysis adjusting for Gleason score, T stage, and prostate-specific antigen, men aged 45-54 years and 55-64 years had 67% and 46% increase in overall survival, respectively, compared to men aged 65-74 years; but these differences were not seen in the 35-44 year age group. There were no differences in prostate cancer specific deaths between the groups. The 5- and 10-year overall survival outcomes were both higher for men aged 45-54 years compared to mean aged 55-74 years (97.9% vs. 95.9% and 94.9% vs. 85.3). Men aged 45-54 years undergoing RP had better overall survival compared to men aged 55-74 years, but these effects were not seen in men aged 35-44 years. There were no differences in prostate cancer specific survival in these groups.