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Erschienen in: International Urology and Nephrology 8/2018

07.07.2018 | Urology - Original Paper

Survival outcomes of locally advanced prostate cancer in patients aged < 50 years after local therapy in the contemporary US population

verfasst von: Wei Sheng, Hongwei Zhang, Yong Lu

Erschienen in: International Urology and Nephrology | Ausgabe 8/2018

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Abstract

Purpose

To assess survival outcomes of locally advanced prostate cancer (LAPC) in patients aged < 50 years after local therapy (LT), as compared to that in the older patients (≥ 50 years). Moreover, effectiveness of postoperative radiation therapy (PRT) after radical prostatectomy (RP) was also assessed in patients aged < 50 years.

Methods

Within the Surveillance, Epidemiology, and End results database (2004–2014), non-metastatic cT3–4 LAPC patients treated with LT (RP, RT or RP+RT) were identified. After propensity score matching (PSM), cancer-specific mortality (CSM), overall survival (OS), and other-cause mortality (OCM) rates were assessed. Multivariable competing risk regression (MVA CRR) model was also used in our analysis.

Results

1507 younger (< 50 years) and 34833 older (≥ 50 years) LAPC patients treated with LT were identified. Younger patients with LAPC had overall more aggressive disease features than their older counterparts. After PSM, younger patients yielded higher cumulative CSM rates than the older patients (P = 0.046). However, OS and cumulative OCM rates were significantly higher (P = 0.038 and P < 0.0001, respectively) in the older cohort. In the MVA CRR model, younger patients yielded higher CSM (P = 0.02). Specifically, younger patients resulted in higher CSM in Gleason score 8–10, cT3b/4 stage, cN1 stage, and patients treated with RP. No statistically significant differences were found in patients treated with RP versus RP+PRT in all parameters.

Conclusions

LAPC patients aged < 50 years yielded higher CSM after LT, specifically after RP, compared with the older counterparts (≥ 50 years). No significant differences were observed in RP versus RP+PRT regarding survival outcomes in our analysis.
Literatur
1.
Zurück zum Zitat Lin DW, Porter M, Montgomery B (2009) Treatment and survival outcomes in young men diagnosed with prostate cancer: a Population-based Cohort Study. Cancer 115:2863–2871CrossRefPubMedPubMedCentral Lin DW, Porter M, Montgomery B (2009) Treatment and survival outcomes in young men diagnosed with prostate cancer: a Population-based Cohort Study. Cancer 115:2863–2871CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Pompe RS, Smith A, Bandini M, Marchioni M, Martel T, Preisser F et al (2018) Tumor characteristics, treatments, and oncological outcomes of prostate cancer in men aged ≤ 50 years: a population-based study. Prostate Cancer Prostatic Dis 21(1):71–77CrossRefPubMed Pompe RS, Smith A, Bandini M, Marchioni M, Martel T, Preisser F et al (2018) Tumor characteristics, treatments, and oncological outcomes of prostate cancer in men aged ≤ 50 years: a population-based study. Prostate Cancer Prostatic Dis 21(1):71–77CrossRefPubMed
3.
Zurück zum Zitat Kinnear NJ, Kichenadasse G, Plagakis S, O’Callaghan ME, Kopsaftis T, Walsh S et al (2016) Prostate cancer in men aged less than 50 years at diagnosis. World J Urol 34:1533–1539CrossRefPubMed Kinnear NJ, Kichenadasse G, Plagakis S, O’Callaghan ME, Kopsaftis T, Walsh S et al (2016) Prostate cancer in men aged less than 50 years at diagnosis. World J Urol 34:1533–1539CrossRefPubMed
4.
Zurück zum Zitat Prendeville S, Nesbitt ME, Evans AJ, Fleshner NE, van der Kwast TH et al (2017) Variant histology and clinicopathological features of prostate cancer in men younger than 50 years treated with radical prostatectomy. J Urol 198:79–85CrossRefPubMed Prendeville S, Nesbitt ME, Evans AJ, Fleshner NE, van der Kwast TH et al (2017) Variant histology and clinicopathological features of prostate cancer in men younger than 50 years treated with radical prostatectomy. J Urol 198:79–85CrossRefPubMed
5.
Zurück zum Zitat Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M et al (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71:618–629CrossRefPubMed Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M et al (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71:618–629CrossRefPubMed
6.
Zurück zum Zitat Bolla M, van Poppel H, Tombal B, Vekemans K, Da Pozzo L, de Reijke TM et al (2012) Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long term results of a randomised controlled trial (EORTC trial 22911). Lancet 380:2018–2027CrossRefPubMed Bolla M, van Poppel H, Tombal B, Vekemans K, Da Pozzo L, de Reijke TM et al (2012) Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long term results of a randomised controlled trial (EORTC trial 22911). Lancet 380:2018–2027CrossRefPubMed
7.
Zurück zum Zitat Wiegel T, Bartkowiak D, Bottke D, Bronner C, Steiner U, Siegmann A et al (2014) Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow up of the ARO 96–02/AUO AP 09/95 trial. Eur Urol 66:243–250CrossRefPubMed Wiegel T, Bartkowiak D, Bottke D, Bronner C, Steiner U, Siegmann A et al (2014) Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow up of the ARO 96–02/AUO AP 09/95 trial. Eur Urol 66:243–250CrossRefPubMed
8.
Zurück zum Zitat Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D et al (2009) Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow up of a randomized clinical trial. J Urol 181:956–962CrossRefPubMedPubMedCentral Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D et al (2009) Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow up of a randomized clinical trial. J Urol 181:956–962CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Hu CY, Xing Y, Cormier JN, Chang GJ (2013) Assessing the utility of cancer-registry-processed cause of death in calculating cancer-specific survival. Cancer 119:1900–1907CrossRefPubMedPubMedCentral Hu CY, Xing Y, Cormier JN, Chang GJ (2013) Assessing the utility of cancer-registry-processed cause of death in calculating cancer-specific survival. Cancer 119:1900–1907CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281CrossRefPubMed D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281CrossRefPubMed
12.
Zurück zum Zitat Gray R (1988) A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat 16:1140–1154CrossRef Gray R (1988) A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat 16:1140–1154CrossRef
13.
14.
Zurück zum Zitat Parker PM, Rice KR, Sterbis JR, Chen Y, Cullen J, McLeod DG, Brassell SA et al (2011) Prostate cancer in men less than the age of 50: a comparison of race and outcomes. Urology 78:110–115CrossRefPubMed Parker PM, Rice KR, Sterbis JR, Chen Y, Cullen J, McLeod DG, Brassell SA et al (2011) Prostate cancer in men less than the age of 50: a comparison of race and outcomes. Urology 78:110–115CrossRefPubMed
15.
Zurück zum Zitat Merrill RM, Bird JS (2002) Effect of young age on prostate cancer survival: a population-based assessment (United States). Cancer Causes Control: CCC 13:435–443CrossRefPubMed Merrill RM, Bird JS (2002) Effect of young age on prostate cancer survival: a population-based assessment (United States). Cancer Causes Control: CCC 13:435–443CrossRefPubMed
16.
Zurück zum Zitat Kaplan JR, Kowalczyk KJ, Borza T, Gu X, Lipsitz SR, Nguyen PL et al (2013) Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy. BJU Int 111:1208–1214CrossRefPubMed Kaplan JR, Kowalczyk KJ, Borza T, Gu X, Lipsitz SR, Nguyen PL et al (2013) Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy. BJU Int 111:1208–1214CrossRefPubMed
17.
Zurück zum Zitat Thorstenson A, Garmo H, Adolfsson J, Bratt O (2017) Cancer specific mortality in men diagnosed with prostate cancer before age 50 years: a nationwide population based study. J Urol 197:61–66CrossRefPubMed Thorstenson A, Garmo H, Adolfsson J, Bratt O (2017) Cancer specific mortality in men diagnosed with prostate cancer before age 50 years: a nationwide population based study. J Urol 197:61–66CrossRefPubMed
18.
Zurück zum Zitat Lange EM, Salinas CA, Zuhlke KA, Ray AM, Wang Y, Lu Y et al (2012) Early onset prostate cancer has a significant genetic component. Prostate 72:147–156CrossRefPubMed Lange EM, Salinas CA, Zuhlke KA, Ray AM, Wang Y, Lu Y et al (2012) Early onset prostate cancer has a significant genetic component. Prostate 72:147–156CrossRefPubMed
19.
Zurück zum Zitat Kluzniak W, Wokolorczyk D, Kashyap A, Jakubowska A, Gronwald J, Huzarski T et al (2013) The G84E mutation in the HOXB13 gene is associated with an increased risk of prostate cancer in Poland. Prostate 73:542–548CrossRefPubMed Kluzniak W, Wokolorczyk D, Kashyap A, Jakubowska A, Gronwald J, Huzarski T et al (2013) The G84E mutation in the HOXB13 gene is associated with an increased risk of prostate cancer in Poland. Prostate 73:542–548CrossRefPubMed
20.
Zurück zum Zitat Gudmundsson J, Sulem P, Gudbjartsson DF, Masson G, Agnarsson BA, Benediktsdottir KR et al (2012) A study based on whole-genome sequencing yields a rare variant at 8q24 associated with prostate cancer. Nat Genet 44:1326–1329CrossRefPubMedPubMedCentral Gudmundsson J, Sulem P, Gudbjartsson DF, Masson G, Agnarsson BA, Benediktsdottir KR et al (2012) A study based on whole-genome sequencing yields a rare variant at 8q24 associated with prostate cancer. Nat Genet 44:1326–1329CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Zheng SL, Sun J, Wiklund F, Smith S, Stattin P, Li G et al (2008) Cumulative association of five genetic variants with prostate cancer. N Engl J Med 358:910–919CrossRefPubMed Zheng SL, Sun J, Wiklund F, Smith S, Stattin P, Li G et al (2008) Cumulative association of five genetic variants with prostate cancer. N Engl J Med 358:910–919CrossRefPubMed
22.
Zurück zum Zitat Lin DW, FitzGerald LM, Fu R, Kwon EM, Zheng SL, Kolb S et al (2011) Genetic variants in the LEPR, CRY1, RNASEL, IL4, and ARVCF genes are prognostic markers of prostate cancer-specific mortality. Cancer Epidemiol Biomark Prev 20:1928–1936CrossRef Lin DW, FitzGerald LM, Fu R, Kwon EM, Zheng SL, Kolb S et al (2011) Genetic variants in the LEPR, CRY1, RNASEL, IL4, and ARVCF genes are prognostic markers of prostate cancer-specific mortality. Cancer Epidemiol Biomark Prev 20:1928–1936CrossRef
23.
Zurück zum Zitat Carver BS, Bianco FJ Jr, Scardino PT, Eastham JA (2006) Long-term outcome following radical prostatectomy in men with clinical stage T3 prostate cancer. J Urol 176:564–568CrossRefPubMed Carver BS, Bianco FJ Jr, Scardino PT, Eastham JA (2006) Long-term outcome following radical prostatectomy in men with clinical stage T3 prostate cancer. J Urol 176:564–568CrossRefPubMed
24.
Zurück zum Zitat Petrovich Z, Lieskovsky G, Stein JP, Huberman M, Skinner DG et al (2002) Comparison of surgery alone with surgery and adjuvant radiotherapy for pT3N0 prostate cancer. BJU Int 89:604–611CrossRefPubMed Petrovich Z, Lieskovsky G, Stein JP, Huberman M, Skinner DG et al (2002) Comparison of surgery alone with surgery and adjuvant radiotherapy for pT3N0 prostate cancer. BJU Int 89:604–611CrossRefPubMed
25.
Zurück zum Zitat Sandler HM, Hu C, Rosenthal SA, Oliver Sartor LG, Gomella, Mahul, Amin et al (2015) A phase III protocol of androgen suppression (AS) and 3DCRT/IMRT versus AS and 3DCRT/IMRT followed by chemotherapy (CT) with docetaxel and prednisone for localized, high-risk prostate cancer (RTOG 0521). J Clin Oncol 33(Suppl):abstr LBA5002CrossRef Sandler HM, Hu C, Rosenthal SA, Oliver Sartor LG, Gomella, Mahul, Amin et al (2015) A phase III protocol of androgen suppression (AS) and 3DCRT/IMRT versus AS and 3DCRT/IMRT followed by chemotherapy (CT) with docetaxel and prednisone for localized, high-risk prostate cancer (RTOG 0521). J Clin Oncol 33(Suppl):abstr LBA5002CrossRef
26.
Zurück zum Zitat James ND, Sydes MR, Mason MD, Clarke NW, Dearnaley DP, Spears MR et al (2015) Docetaxel and/or zoledronic acid for hormone-naïve prostate cancer: first overall survival results from STAMPEDE (NCT00268476). J Clin Oncol 33(Suppl):abstr 5001 James ND, Sydes MR, Mason MD, Clarke NW, Dearnaley DP, Spears MR et al (2015) Docetaxel and/or zoledronic acid for hormone-naïve prostate cancer: first overall survival results from STAMPEDE (NCT00268476). J Clin Oncol 33(Suppl):abstr 5001
27.
Zurück zum Zitat Tao JJ, Visvanathan K, Wolff AC (2015) Long term side effects of adjuvant chemotherapy in patients with early breast cancer. Breast 24(Suppl 2):S149–S153CrossRefPubMedPubMedCentral Tao JJ, Visvanathan K, Wolff AC (2015) Long term side effects of adjuvant chemotherapy in patients with early breast cancer. Breast 24(Suppl 2):S149–S153CrossRefPubMedPubMedCentral
Metadaten
Titel
Survival outcomes of locally advanced prostate cancer in patients aged < 50 years after local therapy in the contemporary US population
verfasst von
Wei Sheng
Hongwei Zhang
Yong Lu
Publikationsdatum
07.07.2018
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 8/2018
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1931-9

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