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Clinical outcomes and prognosis of metastatic prostate cancer patients ≤ 60-year-old

Abstract

Purpose

Metastatic prostate cancer (mPCa) rarely occurs under the age of 60, and we aim to evaluate the clinical outcomes and prognosis of mPCa patients ≤ 60-year-old.

Methods

Two thousand and eighty-three patients were treated with mPCa between April 2003 and May 2020. Clinicopathological characteristics between groups, biochemical recurrence (BCR)-free survival, and overall survival (OS) were assessed. Subgroup analysis was performed on patients ≤ 60 years. Multivariable cox regression was used for survival analysis.

Results

Three hundred and seventy-five patients (> 60 years: older) and 115 patients (≤ 60 years: young) were identified. 5-year BCR-free survival rates were 38.8% in young and 74.1% in older group (p < 0.001). 5-year OS were 88.1% in young and 96.5% in older group (p = 0.006). The significant factor associated with BCR was age > 60 (hazard ratio [HR] = 0.67, 95% confidence [CI]: 0.36–0.94, p = 0.017). The significant predictors of OS were age > 60 (HR 0.40, CI 0.18–0.91, p = 0.028) and local definitive treatment (HR 0.29, CI 0.13–0.64, p = 0.002). For the subgroup analysis, median BCR-free survival was significantly shorter in younger (≤ 56) group (14 mo vs. 27 mo, p = 0.026), and the median OS was significantly different (p = 0.048).

Conclusions

In mPCa patients ≤ 60-year-old, BCR occurs earlier and OS is significantly reduced than older patients. Therefore, special caution is mandatory when treating these mPCa patients.

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No funding was received specifically for this project.

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Authors

Contributions

HK and SKH contributed to protocol/project development; HK and SKH were involved in data collection or management; HK, SL, SSB, and SKH analyzed the data; HK and SKH contributed to manuscript writing/editing; HK, SL, SSB, and SKH were involved in critical review; SKH supervised the study.

Corresponding author

Correspondence to Sung Kyu Hong.

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All authors have no conflict of interest to declare.

Ethical statements

All study protocols were in accordance with the principles of the Helsinki Declaration. We removed personal identifiers and anonymized all data, which exempted the study from the need to obtain informed consent from patients. Institutional review board (IRB) approval of study from Seoul National University Bundang Hospital was obtained (IRB number: B-2007-622-102).

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Cite this article

Kim, H., Lee, S., Byun, SS. et al. Clinical outcomes and prognosis of metastatic prostate cancer patients ≤ 60-year-old. World J Urol (2021). https://doi.org/10.1007/s00345-021-03785-4

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Keywords

  • Metastatic prostate cancer
  • Aged ≤ 60 years
  • Outcomes assessment
  • Prognosis
  • Local definitive treatment