The incidence of prostate cancer in patients under the age of 60 from an urban setting

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Background: Although the risk for developing prostate cancer increases with age, few studies have reported the incidence of prostate cancer in men younger than 60 from an urban setting. Methods: All patients diagnosed and treated for prostate cancer at The Cancer Institute of New Jersey at Cooper University Hospital in Camden County, New Jersey from January 1, 2004 to December 31, 2004 were retrospectively identified from our tumor registry. Age comparison at diagnosis was made utilizing the Cooper registry and the National Cancer Database (NCDB), 2001. Results: A total of 141 men (88 Caucasians, 37 African Americans, 14 Hispanic, and 6 unknown) with a median age of 64 years (range, 44–88 years) were diagnosed with prostate cancer in 2004. Staging revealed Stage II (118), Stage III (3), Stage IV (4), Stage unknown (16) cases. Median Gleason score was 6. 74 patients underwent radical prostatectomy, 50 had radiation, 30 received hormone therapy and 2 received chemotherapy. At diagnosis, 19.95% of the men were under 50 and 41.84% were under 60 years of age. Our dataset from these two age groups compared to NJ and US figures are noted below. Conclusions: When comparing the respective data sets from CINJ at Cooper to NJ and US utilizing the NCDB, there are striking differences with a higher incidence of prostate cancer in younger men. These incidences parallel those seen in other urban university teaching hospitals from the Healthcare Utilization Project (2005), where more patients under the age of 60 are being diagnosed with prostate cancer when compared to community centers. Subset analysis shows that our institution had a disproportionately larger number of African American men with prostate cancer which may relate to our culturally directed screening program, accounting for the higher incidence. These data support that hospital characteristics may impact age at diagnosis of prostate cancer, and further investigation is warranted. [Table: see text]

No significant financial relationships to disclose.

Improved survival in patients with locally advanced esophageal cancer utilizing a multidisciplinary approach

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Background: Locally advanced esophageal cancer studies have reported a three year overall survival rate of 32% with a median survival of 16 months. These patients were treated with combined chemotherapy and radiation with surgery, when applicable. We conducted this study to determine whether using an individualized, multidisciplinary approach affected survival outcomes in patients treated for locally advanced esophageal cancer. Methods: All patients treated for locally advanced esophageal cancer were retrospectively identified from our database at The Cancer Institute of New Jersey at Cooper University Hospital. All patients were presented and discussed in a multidisciplinary gastrointestinal tumor board conference. After a consensus was obtained, a treatment plan was established for each patient based on his or her respective clinical characteristics: stage, performance status, medical suitability for surgery and resectabilty. Results: A total of 23 patients (median age: 66 years [range, 55–88 years]) were identified, the histopathologic diagnosis was adenocarcinoma in 13 and squamous cell carcinoma in 10 cases. TNM staging was as follows: 18 (78.3%) stage II or III and 5 (21.7%) stage IV. Initial management included esophagectomy for 9 (39.1%), 6 of which received preoperative chemotherapy (5-FU) and three received postoperative adjuvant chemotherapy, 14 (60.9%) received only combined chemotherapy (average four cycles of 5FU 1000 mg per square meter of body surface + Cisplatin 75 mg per square meter of body surface) and radiation at doses 50–64 Gy. Overall median survival was not reached since only five patients (21.7%) have died. The 1- year and 2-year survival rates were 87% and 74% respectively. Median follow-up for patients who received combination chemotherapy and radiation vs. surgery with preoperative therapy was 29 and 41 months, respectively. Conclusion: This retrospective analysis shows promising outcomes compared to published data supporting the role of an individualized, multidisciplinary approach in the management of each patient with esophageal cancer.

No significant financial relationships to disclose.