OBJECTIVES: To addressed the biochemical and functional outcomes after radical prostatectomy (RP) of men < 50 years of age in a large European population.
PATIENTS AND METHODS: Among 13268 patients who underwent RP for clinically localized prostate cancer (PCa) at our centre (1992-2011), 443 (3.3%) men < 50 years of age were identified. Biochemical recurrence (BCR) and functional outcomes (International Index of Erectile Function (IIEF-5), use of pads), were prospectively evaluated and compared between men < 50 and older patients.
RESULTS: Men < 50 were more likely to harbour D'Amico low-risk (49.4 vs. 34.9%, p< 0.001), organ-confined (82.6 vs. 69.4%, p<0.0001) and low-grade tumors (Gleason score (GS) < 7: 33.1 vs. 28.7%, p< 0.001). Multivariate Cox regression analysis revealed that age < 50 (HR: 0.99; CI: 0.72-1.31; P=0.9) represented no predictor of BCR. Urinary continence was more favorable in younger patients, resulting in continence rates of 97.4 vs. 91.6% in most recent years (2009-2011) for patients < 50 vs. ≥50 years of age. Postoperatively, a median IIEF-5 drop of 4 points in younger men vs. 8 points in older patients was recorded (< 0.001). Favorable recovery of urinary continence and erectile function in patients younger than 50 years of age compared to their older counterparts was confirmed after multivariable adjustment.
CONCLUSION: Men < 50 years diagnosed with localized PCa should not be discouraged from RP as the postoperative rates of urinary incontinence and erectile dysfunction are low and probability of BCR-free survival at 2 and 5-yrs is high.
Written by:
Becker A, Tennstedt P, Hansen J, Trinh QD, Kluth L, Atassi N, Schlomm T, Salomon G, Haese A, Budaeus L, Michl U, Heinzer H, Huland H, Graefen M, Steuber T. Are you the author?
Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
Reference: BJU Int. 2013 Aug 12. Epub ahead of print.
doi: 10.1111/bju.12407
PubMed Abstract
PMID: 24053677
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