Clinicopathological characteristics of localized prostate cancer in younger men aged ≤ 50 years treated with radical prostatectomy in the PSA era: A systematic review and meta‐analysis

Abstract

Objectives With the rapid increase in younger age prostate cancer (PCa) patients, the impact of younger age on decision‐making for PCa treatment needs to be revaluated in the new era. Materials and Methods A systematic literature search was performed using PubMed, EMBASE, and Web of Science up to October 2019 to identify the eligible radical prostatectomy (RP) studies focusing on understanding the impact of age on clinicopathological features and oncological prognosis in patients with localized PCa in PSA era. Meta‐analyses were conducted using available hazard ratios (HRs) from both univariate and multivariate analyses. Results Twenty‐six studies including 391 068 patients with RP treatments from the PSA era were included. Of these studies, age of 50 years old (age50) is the most commonly used cut‐off age to separate the younger patient group (including either age < 50 or age ≤ 50) from the older patient group. In these studies, the incidence of younger patients varied between 2.6% and 16.6% with a median of 8.3%. Younger patients consistently showed more favorable clinicopathological features correlated with better BCR prognosis. Meta‐analyses showed a 1.38‐fold improved BCR survival of younger patients in multivariate analysis. Among the high‐risk PCa patients, younger age was independently associated with worse oncological outcomes in multivariate analyses. Conclusion In this study, we found younger age correlated with favorable clinicopathological characteristics and better BCR prognosis in low‐ to intermediate‐risk patients. In high‐risk group patients, younger patients often showed significantly worse oncological outcomes. Our study results suggest that age 50 could be used as a practical cut‐off age to separate younger age patients from older age PCa patients.

Men in rural Nigeria have a poor perception of prostate cancer risk; Hence they seldom seek screening

“…Age is, although a social construct, has biological implications. The clinicopathological feature of PCa in middle age is more favorable and offers higher survival 35 . Hypothetically, persons above the mid‐age are at higher risk of biochemical recurrence.…”

Reduced survival of young patients under 55 years with metastatic prostate cancer: a population-based study

“…The detailed survival time of patients is affected by many factors, such as age, ethnicity, genetic factors etc. [10,11]. In addition to tumor factors, age is one of the most important factors that has great effects on the prognosis of men with mPCa [10].…”

“…PCa is very rare among young patients and might be more aggressive in terms of biological behavior. Zheng et al [11] reported that younger patients were associated with significantly worse outcomes in high-risk group patients. For young patients with mPCa, the detailed survival outcomes remain inconclusive.…”

Cáncer de próstata de inicio temprano. ¿Una nueva entidad?

“…El punto de cohorte de la edad no está establecido, pero se considera de inicio temprano si el paciente es menor de 50 años, sin embargo otros estudios lo han establecido en menores de 60, 55 y 45 años de edad. (11) En Estados Unidos en el año 2012 cerca del 10% de los hombres con CP (241 740 personas) fueron diagnosticados antes de los 55 años. (12) En un estudio realizado con los datos obtenidos de SEER (The Surveillance, Epidemiology, and End Results) que incluyó el análisis de 30 338 pacientes con CP durante 1998 y 2003, determinó que el 9% eran pacientes ≤55 años.…”

“…(1.09-1.74)), (11) en este análisis se incluyeron tres estudios. (19)(20)(21) Sin embargo, en los jóvenes con CP de alto riesgo se observó asociación con peores desenlaces oncológicos.…”