Clinicopathological and Prognostic Factors in 106 Prostate Cancer Patients Aged ≤55 Years: A Single-Center Study in China

Abstract

BackgroundEarly-onset prostate cancer patients (aged ≤55 years) from Western countries have been well characterized in previous studies. However, the clinicopathological and prognostic characteristics of early-onset Chinese prostate cancer patients have not yet been assessed. This study aimed to examine the clinicopathological and prognostic factors of prostate cancer patients aged ≤55 years in a single Chinese center.Material/MethodsOne hundred six prostate cancer patients aged ≤55 years with complete clinicopathological data who were treated at our hospital between January 2000 and June 2014 were selected for this study. Survival rate was investigated by Kaplan-Meier analysis, and prognostic factors were examined by univariate and multivariate analysis.ResultsThe median time from the onset of symptoms to diagnosis was 3.5 months (range, 2–55 months). The median time after endocrine therapy to development of androgen-independent prostate cancer was 10.5 months. A total of 54 patients died (50.9%), of whom 96.2% died from prostate cancer. The 1-, 3-, and 5-year overall survival rates were 88.7%, 66.2%, and 36.0%, respectively. Univariate and multivariate analysis showed that T staging, visceral metastasis, pathological pattern, and Gleason sum were independent prognostic factors in these patients.ConclusionsProstate cancer patients aged ≤55 years are often omitted or misdiagnosed in China. Furthermore, the pathology patterns in this age group were mostly complicated with a high degree of malignancy. Late staging, visceral metastasis, pathological pattern, and high Gleason score were independent prognostic factors in these patients. Comprehensive therapy combined with local therapy is an effective treatment strategy.

How Much Reliable Is the Current Belief on Grade Group 1 Prostate Cancer?

“…It is well known that patients with prostate cancer in Asian countries present with more aggressive pathologic features, compared to Western men [ 24 , 25 ]. Especially for Korean patients, prostate cancer in Korean men is known to be more aggressive and exhibit poorer differentiation, regardless of the initial serum PSA level or clinical stage at presentation, than that of Western men [ 26 ].…”

“…The new GG system was validated in two large cohorts (men treated with radical prostatectomy (RP) or radiation), and both studies discovered that GGs predicted the risk of recurrence following the primary treatment [1,2]. In the larger study, the five-year biochemical recurrence (BCR)-free progression probabilities after RP for GGs 1 through 5 were 96% (95% confidence interval (CI), 95-96), 88% (95% CI, 85-89), 63% (95% CI, 61-65), 48% (95% CI, 44-52), and 26% (95% CI, [23][24][25][26][27][28][29][30], respectively [1]. Other studies also supported the validity of this new system [3,4].…”

Pathological Characteristics of Prostate Cancer in Men Aged < 50 Years Treated with Radical Prostatectomy: a Multi-Centre Study in Korea

“…Huang et al 19 compared the pathological characteristics and prognosis of patients with PCa in Taipei, between young and old age groups, and reported that patients with PCa aged < 50 years showed similar tumour grades, stages, PSA values, overall survival (OS), and BFSs to the older aged group. The Chinese study of Xu et al 8 reported that patients with PCa aged < 55 years are more likely to be diagnosed at an advanced stage, and their pathologic patterns were mostly complicated and associated with a high degree of malignancy. They demonstrated that the five-year OS of their younger group was significantly lower than that of European and American populations.…”

“…It is well known that patients with PCa in Asian countries present with more aggressive pathologic features, compared with Western men. 8 9 Man et al 9 reported that a greater proportion of Asian people had a high risk PCa compared with non-Asian men. The percentage of PCa with GS ≥ 8 was twice as high in Asian patients than in non-Asians at presentation (26.5% vs. 13.8%, respectively).…”

“…Generally, it is well-known that patients with PCa in Asian countries present with more aggressive pathologic behaviours, in contrast to Western men. 8 9 Accordingly, it is crucial to determine the pathologic features and prognosis of young patients with PCa in the Asian population. To address these issues, using a recent prostatectomy database, we analysed the clinicopathological characteristics of a multi-centre cohort of Korean men with PCa, comparing patients < 50-year-old to patients ≥ 50-year-old.…”