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Li J, Cai Z, Wei W, Wang X, Peng X. Establishment of Prognostic Nomograms for Early-Onset Prostate Cancer Patients: A SEER Database Analysis. J INVEST SURG 2022; 35:1581-1590. [PMID: 35414345 DOI: 10.1080/08941939.2022.2062495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Clinical prostate cancer (PCa) is rare in men aged <50 years (early-onset). A well-designed nomogram for prognosis prediction in patients with early-onset PCa has not been studied. Here, we tried to establish nomogram models of overall survival (OS) and cancer-specific survival (CSS) in patients with early-onset PCa. METHODS The clinical variables of patients diagnosed with early-onset PCa between 2004 and 2016 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training and validation groups at a ratio of 7:3. Multivariate Cox regression analyses were used to select prognostic factors associated with OS or CSS, followed by the construction and validation of nomograms. RESULTS We enrolled 8259 patients with early-onset PCa. New nomograms were established and showed good discriminative abilities. Finally, ROC curve analysis demonstrated that these nomograms were superior to the TNM stage and Gleason score in predicting both OS and CSS for patients with early-onset PCa. CONCLUSION This is the first study to establish nomograms with effective and high accuracy for prognosis in patients with early-onset PCa.
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Affiliation(s)
- Jingtao Li
- Department of Urology, The Second Affiliated Hospital of Jianghan University, Wuhan, China
| | - Zhen Cai
- Department of Operation Room, The Second Affiliated Hospital of Jianghan University, Wuhan, China
| | - Wei Wei
- Department of Urology, The Second Affiliated Hospital of Jianghan University, Wuhan, China
| | - Xia Wang
- Department of Pharmacy, The Second Affiliated Hospital of Jianghan University, Wuhan, Hubei, China
| | - Xiulan Peng
- Department of Oncology, The Second Affiliated Hospital of Jianghan University, Wuhan, China
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Baniak N, Sholl LM, Mata DA, D'Amico AV, Hirsch MS, Acosta AM. Clinicopathological and molecular characteristics of prostate cancer diagnosed in young men aged up to 45 years. Histopathology 2021; 78:857-870. [PMID: 33306242 DOI: 10.1111/his.14315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/30/2022]
Abstract
AIMS To characterise and compare the poorly understood clinicopathological and molecular characteristics of prostatic adenocarcinoma (PCa) in very young patients. METHODS AND RESULTS We compared the clinicopathological and molecular characteristics of PCa diagnosed in 90 patients aged ≤45 years with those of PCa diagnosed in 200 patients of typical screening age (i.e. 60-65 years). Patients diagnosed at a younger age had a higher frequency of a family history of PCa and lower prostate-specific antigen (PSA) levels than those diagnosed at regular screening age. There were no statistically significant differences in clinical stage or pathological characteristics of the core biopsy specimens between the groups. Young patients had a higher frequency of Grade Group 1 disease at radical prostatectomy. A subset of 13 aggressive PCa cases from young patients underwent successful DNA-based next-generation sequencing. In all, 46.2% (6/13) had TMPRSS2 rearrangements and 23.1% (3/13) had relevant pathogenic variants in DNA damage repair genes, including a mismatch repair-deficient case with biallelic inactivation of MLH1. No statistically significant differences were observed in PCa-specific recurrence/progression between the younger and older patients, including after adjustment for clinical stage, PSA level, and Grade Group. CONCLUSIONS In this study, the clinicopathological and molecular features of PCa diagnosed in young patients were comparable to those of PCa diagnosed in patients of screening age. Early-onset PCa cases were not enriched in any of the known molecular PCa subtypes in this small series.
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Affiliation(s)
- Nicholas Baniak
- Department of Pathology, Genitourinary Pathology Division, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lynette M Sholl
- Harvard Medical School, Boston, MA, USA.,Department of Pathology, Molecular Pathology Division (Center for Advanced Molecular Diagnostics), Brigham and Women's Hospital, Boston, MA, USA
| | | | - Anthony V D'Amico
- Department of Radiation Oncology, Genitourinary Radiation Oncology Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Michelle S Hirsch
- Department of Pathology, Genitourinary Pathology Division, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Andres M Acosta
- Department of Pathology, Genitourinary Pathology Division, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Gielchinsky I, Chang J, Cusick T, Delprado W, Nguyen Q, Yuen C, Savdie R, Böhm M, Haynes AM, Scheltema MJ, Stricker PD. Prostate cancer in 432 men aged <50 years in the prostate-specific antigen era: a new outlook. BJU Int 2018; 122 Suppl 5:35-41. [DOI: 10.1111/bju.14586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Ilan Gielchinsky
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
- St Vincent's Prostate Cancer Centre; Darlinghurst NSW Australia
| | - John Chang
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
- St Vincent's Prostate Cancer Centre; Darlinghurst NSW Australia
| | - Thomas Cusick
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
| | - Warick Delprado
- Douglass Hanly Moir Pathology; Macquarie Park NSW Australia
- School of Medicine; University of New South Wales; Kensington NSW Australia
| | - Quoc Nguyen
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
| | - Carlo Yuen
- School of Medicine; University of New South Wales; Kensington NSW Australia
- St Vincent's Clinic; Sydney NSW Australia
| | - Richard Savdie
- School of Medicine; University of New South Wales; Kensington NSW Australia
- St Vincent's Clinic; Sydney NSW Australia
| | - Maret Böhm
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
| | - Anne-Maree Haynes
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
| | - Matthijs J. Scheltema
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
- St Vincent's Prostate Cancer Centre; Darlinghurst NSW Australia
| | - Phillip D. Stricker
- Garvan Institute of Medical Research; Kinghorn Cancer Centre; Darlinghurst NSW Australia
- St Vincent's Prostate Cancer Centre; Darlinghurst NSW Australia
- School of Medicine; University of New South Wales; Kensington NSW Australia
- St Vincent's Clinic; Sydney NSW Australia
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Miszczyk L, Namysł Kaletka A, Napieralska A, Woźniak G, Stąpór Fudzińska M, Głowacki G, Tukiendorf A. Cyberknife Radioablation of Prostate Cancer – Preliminary Results for 400 Patients. Asian Pac J Cancer Prev 2017; 18:1007-1013. [PMID: 28545199 PMCID: PMC5494208 DOI: 10.22034/apjcp.2017.18.4.1007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objectives: To evaluate the tolerance and effectiveness of stereotactic ablative radiotherapy (SABR) applied in
the treatment of low and intermediate risk (LR & IR) prostate cancer patients (PCP) and provide an evaluation of the
level of risk group impact on treatment results. In addition, androgen deprivation therapy (ADT) usage and prostatic
specific antigen (PSA) decline after SABR were assessed. Material and Methods: A total of 400 PCP (213 LR and
187 IR, including T2c) were irradiated with a CyberKnife using fd 7.25 Gy to TD 36.25 Gy. At the start of treatment,
60.3% of patients were undergoing ADT and this gradually decreased to 0% after 38 months. Follow-up was for a
median of 15.0 months. Patients were monitored on SABR completion and 1, 4, 8 months later and then subsequently
every 6 months. GI (Gastro-Intestinal) and GU (Genito-Urinary) acute and late adverse effects, PSA and ADT usage
were evaluated. Results: Failure was noted in 9 patients (2.25%) (5 in LR and 4 in IR groups) - 4 relapses and 5 nodal
metastases. No G3/4 late adverse effects (EORTC/RTOG) were observed. Some 0.5% of G3 GU and 0.3% of G3 GI
acute reactions were noted respectively on the SABR completion day and one month later. The median of PSA declined
1.5 ng/ml during the first month and 0.6 ng/ml during the next three months. No impact of risk groups on treatment
results was found. An impact of ADT on PSA decline was only confirmed for time point interactions. Conclusions:
SABR for LR and IR PCP is a safe and effective treatment. The inclusion of T2c patients and the low percentage of
IR patient failure permit us the assumption that this procedure could be utilized in the treatment of more advanced
cases. The results do not allow clear definition of the impact of ADT on radioablation results in LR and IR+ T2c cases.
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Affiliation(s)
- Leszek Miszczyk
- Radiotherapy Department, M. Sklodowska-Curie Memorial
Cancer Center and Institute of Oncology, Gliwice Branch, Poland.
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Situmorang GR, Umbas R, Mochtar CA, Santoso RB. Prostate Cancer in Younger and Older Patients: Do We Treat Them Differently? Asian Pac J Cancer Prev 2012; 13:4577-80. [DOI: 10.7314/apjcp.2012.13.9.4577] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Astigueta J, Abad M, Morante C, Pow-Sang M, Destefano V, Montes J. Patrón de presentación del cáncer de próstata avanzado en pacientes menores de cincuenta años. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2009.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Khan FA, Kaisary AV, Boustead GB, Gillatt DA, Winkler MH. PSA recurrence following radical prostatectomy is comparable for all age groups in the UK. Prostate Cancer Prostatic Dis 2005; 8:158-62. [PMID: 15768048 DOI: 10.1038/sj.pcan.4500786] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
UNLABELLED Increasing numbers of men are being diagnosed with prostate cancer and undergo operative curative treatment. It has been suggested that outcome after radical prostatectomy (RP) may vary for different age groups. OBJECTIVE To investigate whether PSA recurrence-free survival after RP is related to age at operation for a cohort of English men. METHODS A total of 854 patients notes from four Urology units were audited for preoperative staging parameters and follow-up data obtained. The relationship of PSA, age, biopsy Gleason grade, clinical stage, era and institution on PSA recurrence-free survival was competitively assessed with a multivariate model. RESULTS Only preoperative PSA (P<0.0001) and biopsy Gleason grade (P < 0.0001) were found to be strongly associated with PSA recurrence-free survival on multivariate analysis. PSA recurrence-free survival probabilities at 5 y for patients aged 45-55 y, 55.1-60 y, 60.1-65 y, 65.1-70 y and 70.1-75 y were 0.59 (CI 0.47-0.71), 0.74 (CI 0.64-0.784), 0.56 (CI 0.44-0.68), 0.61 (CI 0.53-0.69) and 0.60 (CI 0.46-0.74), respectively. No significant difference of PSA recurrence-free survival between any of the age groups was found (Log-rank, P = 0.8567). CONCLUSION No significant difference of pathological variables or biochemical recurrence across the age groups was found. The widely held belief of poorer outcome in younger men selected for RP does not seem to be borne out by this study.
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Goetzl MA, Desai M, Mansukhani M, Goluboff ET, Katz AE, Sawczuk IS, Benson MC, Olsson CA, McKiernan JM. Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult. Urology 2004; 63:41-5. [PMID: 14751345 DOI: 10.1016/j.urology.2003.08.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To determine the natural history of patients younger than 40 years (young patient [YP] group) who are diagnosed with a sporadic renal cortical tumor (RCT) and to compare the natural history of these patients with the more typical older patient (OP) with RCT. METHODS We reviewed our database and identified 34 patients (younger than 40 years old, median age 35) who underwent surgery for a sporadic RCT. The YP group outcomes were compared with 100 patients between 41 and 85 years (median 65). We fit a Cox proportional hazards model to examine the relationship between age at presentation and recurrence risk. RESULTS The median tumor size in the YP group was 3.8 cm (range 0.6 to 19) and in the OP group was 5.0 cm (range 0.9 to 22; P = 0.225). Tumors were discovered incidentally in 51% and 56% of the YP and OP groups, respectively (P = 0.65). The frequency of partial nephrectomy did not differ between the two groups (35% YP and 30% OP, P = 0.55). The frequency of malignant histologic subtypes did not differ between the groups (P = 0.439). In the YP group, only larger tumor size (hazard ratio 1.23, 95% confidence interval 1.02 to 1.50, P = 0.034) was associated with a statistically significant increased risk of recurrence. Those in the YP group were not more or less likely to develop recurrence than those in the OP group (hazard ratio 0.79, 95% confidence interval 0.22 to 2.85, P = 0.72). The 5-year disease-free survival rate was 73% and 80% in the YP and OP groups, respectively (P = 0.23). The 5-year disease-specific survival rate was 85% and 84% in the YP and OP groups, respectively (P = 0.88). CONCLUSIONS The findings of our study indicate that the natural history of RCTs is similar in both younger and older patients. Young patients were neither more nor less likely to develop recurrence compared with their older counterparts.
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Affiliation(s)
- Manlio A Goetzl
- Department of Urology, Columbia University College of Physicians & Surgeons and Columbia University Mailman School of Public Health, New York, New York 10032, USA
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Varkarakis J, Pinggera GM, Sebe P, Berger A, Bartsch G, Horninger W. Radical retropubic prostatectomy in men younger than 45 years diagnosed during early prostate cancer detection program. Urology 2004; 63:337-41. [PMID: 14972485 DOI: 10.1016/j.urology.2003.09.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2003] [Accepted: 09/17/2003] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the incidence and outcome of prostate cancer in men younger than 45 years of age treated with radical retropubic prostatectomy after screening in an early prostate cancer detection program. METHODS Our study group comprised 19,302 men younger than 45 years old who participated in this program. The indications for prostate biopsy were a prostate-specific antigen (PSA) level of 1.25 ng/mL or greater and a percent-free PSA value of 18% or less. Patients with prostate cancer underwent nerve-sparing radical retropubic prostatectomy. Intraoperative and early postoperative complications, clinical and pathologic stage, Gleason score, and surgical margins were reviewed retrospectively. In addition, potency, continence, and biochemical recurrence were assessed at the last follow-up visit. RESULTS Of the study population eligible for prostate biopsy (1027 patients), only 175 (17%) consented to undergo the procedure (mean PSA 3.8 ng/mL). Twenty-eight men were diagnosed with prostate cancer, corresponding to 0.14% of the screened population and 16% of the biopsied patients. Twenty-six patients agreed to undergo radical retropubic prostatectomy. Pathologic examination revealed organ-confined disease in 22 (84.6%) and extraprostatic extension in 4 (15.4%). Positive surgical margins were seen in 2 patients (7.7%). The Gleason score was 7 or greater in 11 (42.3%) and 6 or less in 15 patients (57.7%). During a mean follow-up period of 15.8 months (range 3 to 36), all patients were continent, and 13 of the 16 patients with a follow-up of 12 months or longer were potent. CONCLUSIONS In a large screening population younger than 45 years old, 16% of biopsied patients were positive for prostate cancer. These tumors were clinically significant but of a low stage and therefore potentially curable by surgery.
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Affiliation(s)
- John Varkarakis
- Department of Urology, Innsbruck University, Innsbruck, Austria
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