Patrón de presentación del cáncer de próstata avanzado en pacientes menores de cincuenta años

Astigueta, Juan Carlos; Abad, Milagros; Morante, Carlos; Pow‐Sang, Mariela; Destefano, V.; Montes, Jaime

doi:10.1016/j.acuro.2009.09.008

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…However, a Spanish retrospective analysis of 69 patients under 50 years of age diagnosed with PCa found that 60% had metastatic tumors at initial diagnosis. In this patient collective, mean survival was 16.1 months (1–84), and all patients died due to disease progression [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Age-Adjusted PSA Levels in Prostate Cancer Prediction: Updated Results of the Tyrol Prostate Cancer Early Detection Program

et al. 2015

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ObjectiveTo reduce the number of unnecessary biopsies in patients with benign prostatic disease, however, without missing significant PCa the present study re-evaluates the age-dependent PSA cut-offs in the Tyrol Prostate Cancer (PCa) early detection program.Patients and MethodsThe study population included 2225 patients who underwent prostate biopsy due to elevated PSA levels at our department. We divided our patient collective into four age groups: ≤49 years (n = 178), 50-59 years (n = 597), 60-69 years (n = 962) and ≥70 years (n = 488). We simulated different scenarios for PSA cut-off values between 1.25 and 6 ng/mL and fPSA% between 15 and 21% for all four age groups and calculated sensitivity, specificity, confidence intervals and predictive values.ResultsPCa was detected in 1218 men (54.7%). We found that in combination with free PSA ≤21% the following PSA cut-offs had the best cancer specificity: 1.75 ng/ml for men ≤49 years and 50-59 years, 2.25 ng/ml for men aged 60-69 years and 3.25 ng/ml for men ≥70 years. Using these adjusted PSA cut-off values all significant tumors are recognized in all age groups, yet the number of biopsies is reduced. Overall, one biopsy is avoided in 13 to 14 men (number needed to screen = 13.3, reduction of biopsies = 7.5%) when decision regarding biopsy is done according to the “new” cut-off values instead of the “old” ones. For the different age groups the number needed to screen to avoid one biopsy varied between 9.2 (≤49 years) and 17.4 (50-59 years).ConclusionWith “new”, fine-tuned PSA cut-offs we detect all relevant PCa with a significant reduction of biopsies compared to the “old” cut-off values. Optimization of age-specific PSA cut-offs is one step towards a smarter strategy in the Tyrol PCa Early Detection Program.

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Section: Discussionmentioning

confidence: 99%

Age-Adjusted PSA Levels in Prostate Cancer Prediction: Updated Results of the Tyrol Prostate Cancer Early Detection Program

et al. 2015

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“…From this study, it also appears that Ogonis and Ijaws developed adenocarcinoma of the prostate at younger ages than Ibos or that Ogonis and Ijaws harbored more aggressive variants of the disease than Ibos, since adenocarcinoma of the prostate occurring in younger age groups has been known to have worse prognosis than that seen in the elderly. [ 20 ] Two theoretical concepts, however, make spurious simple conclusions on times of initiation of adenocarcinoma of the prostate in patients of this population groups. These are the concepts of total preclinical phase (T PCP) and length bias.…”

Section: Discussionmentioning

confidence: 99%

Ethnicity and prostate cancer in Southern Nigeria: A preliminary report

2015

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Introduction:The natural history of prostate cancer varies among patients. The aim of this study is to detect any variations in clinical and pathological characteristics of the tumor in patients from different ethnic groups in Southern Nigeria.Patients and Methods:Consecutive patients who presented with features of prostatic diseases at the Urology Units of University of Port Harcourt Teaching Hospital, Port Harcourt and Nnamdi Azikiwe University Teaching Hospital, Nnewi, were evaluated prospectively with history, physical examination, and relevant investigations using a proforma. Data obtained were collated and analyzed statistically using the Chi-square test and Microsoft Excel.Results:Of 187 patients studied, 169 were analyzed. Eighty-six were Ibos, 31 Ijaws, 25 Ikwerres, and 12 Ogonis. Two were from each Etche, Urhobo, Opobo, and Effik; 4 from Andoni, and 3 Ibibio. Fifty-seven (66.3%) Ibos presented with the disease at higher ages (70–80 years) than 19 (61.3%) Ijaws and 11 (91.7%) Ogonis. These age differences were statistically significant with 95% and 99.9% confidence, respectively. All cases were adenocarcinomas. Clinical features, pattern of serum prostate-specific antigen levels, grades of the tumors, tumor metastases, and complications were similar for all ethnic groups. Although more Ibos had tumors with relatively more aggressive metastatic features, there was no statistical significance.Conclusion:Clinical and pathological features of adenocarcinoma of the prostate in Ibos, Ikwerres, Ijaws, and Ogonis were found to be similar. However, Ibos presented with the disease at older ages than Ijaws and Ogonis.

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“…[ 8 ] In another retrospective analysis by Astigueta et al , 41 patients of prostate cancer under 50 year of age were identified from 1952–2005. [ 2 ] All patients had bone metastasis. In addition, 20 patients had retroperitoneal metastasis, 3 patients had mediastinal lymph node metastasis, 4 had liver, 3 had lung, and 1 patient had testicular metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors which may be associated prostate cancer in young males are abnormality on hereditary prostate cancer 1 (HPC1) gene, race (more common in African American), smoking, fat rich diet, obesity and family history of prostate cancer. [ 2 ] It has been reported by Carter et al , that 43% patients of prostate cancer under 55 years of age are hereditary. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

“…The Surveillance, Epidemiology, and End Results (SEER) database in 1989–2003 has shown that the prognosis of young men with prostate cancer is worse than that of elderly men as most young patients present with distant metastases and have poorly differentiated or undifferentiated histology. [ 2 ] We, here, are reporting a case of prostate cancer in a 28-year-old male who presented with bone metastases.…”

Section: Introductionmentioning

confidence: 99%

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Metastatic adenocarcinoma of prostate in a 28-year-old male: The outcome is poor in young patients?

Madan

Singh

Haresh

et al. 2015

Indian J Palliat Care

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Prostate cancer is common in older patients. Rarity in younger population limits the study of natural history and prognosis in this population. Most of the published data has reported poor outcome in younger patients with metastatic prostate cancer. Here, we report a case of prostate cancer in 28-year-old male who presented with bone metastasis. After bilateral inguinal orchidectomy, he was started on anti-androgen therapy and received palliative radiotherapy for bone metastasis. There was only a slight decrease in prostate-specific antigen (PSA) level and pelvic disease post treatment. Subsequently, he was started on opioid analgesics (by World Health Organization, WHO, step ladder) in view of persistent pain. The index case is being presented for its rarity and probable poor outcome in young patients and to stress on the fact that the possibility of primary prostatic adenocarcinoma should be investigated in a male presenting with bone metastasis irrespective of the age.

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Patrón de presentación del cáncer de próstata avanzado en pacientes menores de cincuenta años

Abstract: Advanced prostate cancer is an uncommon condition in young adults. Its clinical presentation is atypical, as metastases may mimic other diseases. The course of disease is indolent, and prognosis is poor. In patients with risk factors, PSA testing should be started before 50 years of age.

Cited by 10 publications

References 24 publications

Age-Adjusted PSA Levels in Prostate Cancer Prediction: Updated Results of the Tyrol Prostate Cancer Early Detection Program

Age-Adjusted PSA Levels in Prostate Cancer Prediction: Updated Results of the Tyrol Prostate Cancer Early Detection Program

Ethnicity and prostate cancer in Southern Nigeria: A preliminary report

Metastatic adenocarcinoma of prostate in a 28-year-old male: The outcome is poor in young patients?

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