Skip to main content

Advertisement

Log in

Survival outcomes of Asian younger men (< 55 years) undergoing radical prostatectomy: a review of prostate cancer database in a tertiary hospital in Singapore

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Prostate cancer largely affects older men. This study aims to investigate prostate cancer in younger men (< 55 years) to shed light on the survival outcomes of this unique subset of patients in Asian context.

Methods

Data were obtained from the Singapore General Hospital Prostate Cancer Registry. Data on all men with clinically organ confined prostate cancer who underwent radical prostatectomy between 1998 and 2016 were obtained from the registry. Tumor characteristics, follow-up data, and cause of death were acquired.

Results

A total of 1120 men underwent radical prostatectomy between 1998 and 2016. Of these, 12 were aged ≤ 44 years, 106 were aged 45–54 years, 596 were aged 55–64, 397 were aged 65–74 and 9 were aged ≥ 75. There was no difference across age groups when comparing Gleason ≤ 7 vs Gleason ≥ 8 disease, T1/2 vs T3/4 disease and the median PSA values were similar. No difference was observed in overall survival or prostate cancer specific survival among 4 age groups (≤ 44, 45–54, 55–64, 65–74) (p = 0.156 and p = 0.227 respectively). Although there was a trend of increasing rate of biochemical recurrence for older patients, it’s not statistically significant (p = 0.157). Time to biochemical recurrence was similar as well (p = 0.257).

Conclusion

This large cohort of Asian patients who underwent radical prostatectomy did not show significant age-related differences in important parameters and outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Singapore Cancer Registry 50th Anniversary Monograph (1968–2017) published 2019. https://www.nrdo.gov.sg/publications/cancer. Accessed 31 Mar 2020

  2. Tjaden HB, Culp DA, Flocks RH (1965) Clinical adenocarcinoma of the prostate in patients under 50 years of age. J Urol 93:618–621

    CAS  PubMed  Google Scholar 

  3. Byar DP, Mostofi FK (1969) Cancer of the prostate in men less than 50 years old: an analysis of 51 cases. J Urol 102(6):726–733

    CAS  PubMed  Google Scholar 

  4. Silber I, McGavran MH (1971) Adenocarcinoma of the prostate in men less than 56 years old: a study of 65 cases. J Urol 105(2):283–285

    CAS  PubMed  Google Scholar 

  5. Johnson DE, Lanieri JP Jr, Ayala AG (1972) Prostatic adenocarcinoma occurring in men under 50 years of age. J Surg Oncol 4(3):207–216

    CAS  PubMed  Google Scholar 

  6. Salinas CA et al (2014) Prostate cancer in young men: an important clinical entity. Nat Rev Urol 11(6):317–323

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Smith CV et al (2000) Prostate cancer in men age 50 years or younger: a review of the Department of Defense Center for Prostate Disease Research multicenter prostate cancer database. J Urol 164(6):1964–1967

    CAS  PubMed  Google Scholar 

  8. Benson MC, Kaplan SA, Olsson CA (1987) Prostate cancer in men less than 45 years old: influence of stage, grade and therapy. J Urol 137(5):888–890

    CAS  PubMed  Google Scholar 

  9. Huben R et al (1982) Carcinoma of prostate in men less than fifty years old. Data from American College of Surgeons' National Survey. Urology 20(6):585–588

    CAS  PubMed  Google Scholar 

  10. Werthman P et al (1992) Carcinoma of prostate in men aged fifty and under: therapeutic options. Urology 39(1):48–51

    CAS  PubMed  Google Scholar 

  11. Aprikian AG, Zhang ZF, Fair WR (1994) Prostate adenocarcinoma in men younger than 50 years. A retrospective review of 151 patients. Cancer 74(6):1768–1777

    CAS  PubMed  Google Scholar 

  12. Catalona WJ et al (1993) Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 270(8):948–954

    CAS  PubMed  Google Scholar 

  13. Catalona WJ et al (1991) Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 324(17):1156–1161

    CAS  PubMed  Google Scholar 

  14. Howlader N, Noone A, Krapcho M, Noone AM et al (2012) SEER cancer statistics review, 1975–2009 (vintage 2009 populations). National Cancer Institute, Bethesda

    Google Scholar 

  15. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30

    PubMed  Google Scholar 

  16. Stephenson RA, Stanford JL (1997) Population-based prostate cancer trends in the United States: patterns of change in the era of prostate-specific antigen. World J Urol 15(6):331–335

    CAS  PubMed  Google Scholar 

  17. SEER18 Surveillance, Epidemiology, and End Results (SEER) Stat Database. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 31 Mar 2020

  18. Bleyer A, Spreafico F, Barr R (2020) Prostate cancer in young men: an emerging young adult and older adolescent challenge. Cancer 126(1):46–57

    PubMed  Google Scholar 

  19. Thorstenson A et al (2017) Cancer specific mortality in men diagnosed with prostate cancer before age 50 years: a nationwide population based study. J Urol 197(1):61–66

    PubMed  Google Scholar 

  20. 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(13):2863–2871

    PubMed  Google Scholar 

  21. Khoo HS, Lim YW, Vrijhoef HJ (2014) Primary healthcare system and practice characteristics in Singapore. Asia Pac Fam Med 13(1):8

    PubMed  PubMed Central  Google Scholar 

  22. Daniyal M et al (2014) Epidemiology, etiology, diagnosis and treatment of prostate cancer. Asian Pac J Cancer Prev 15(22):9575–9578

    PubMed  Google Scholar 

  23. Kimura T, Egawa S (2018) Epidemiology of prostate cancer in Asian countries. Int J Urol 25(6):524–531

    PubMed  Google Scholar 

  24. Ito K (2014) Prostate cancer in Asian men. Nat Rev Urol 11(4):197–212

    PubMed  Google Scholar 

  25. Kimura T (2012) East meets West: ethnic differences in prostate cancer epidemiology between East Asians and Caucasians. Chin J Cancer 31(9):421–429

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Kong DP et al (2020) Prevalence and clinical application of TMPRSS2-ERG fusion in Asian prostate cancer patients: a large-sample study in Chinese people and a systematic review. Asian J Androl. 22(2):200–207. https://doi.org/10.4103/aja.aja_45_19

    Article  PubMed  Google Scholar 

  27. Mao X et al (2010) Distinct genomic alterations in prostate cancers in Chinese and Western populations suggest alternative pathways of prostate carcinogenesis. Cancer Res 70(13):5207–5212

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Xue L et al (2012) Chinese and Western prostate cancers show alternate pathogenetic pathways in association with ERG status. Am J Cancer Res 2(6):736–744

    PubMed  PubMed Central  Google Scholar 

  29. Miyagi Y et al (2010) ETS family-associated gene fusions in Japanese prostate cancer: analysis of 194 radical prostatectomy samples. Mod Pathol 23(11):1492–1498

    PubMed  Google Scholar 

  30. Lee K et al (1268e) TMPRSS2-ERG gene fusion and clinicopathologic characteristics of Korean prostate cancer patients. Urology 76(5):1268e7–1268e13

    Google Scholar 

  31. Hussein S, Satturwar S, Van der Kwast T (2015) Young-age prostate cancer. J Clin Pathol 68(7):511–515

    CAS  PubMed  Google Scholar 

  32. Ewing CM et al (2012) Germline mutations in HOXB13 and prostate-cancer risk. N Engl J Med 366(2):141–149

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Ostrander EA, Johannesson B (2008) Prostate cancer susceptibility loci: finding the genes. Adv Exp Med Biol 617:179–190

    PubMed  PubMed Central  Google Scholar 

  34. Tan L et al (2018) Survival outcomes of younger men (%3c 55 years) undergoing radical prostatectomy. Prostate Int 6(1):31–35

    PubMed  Google Scholar 

  35. Becker A et al (2014) Functional and oncological outcomes of patients aged %3c 50 years treated with radical prostatectomy for localised prostate cancer in a European population. BJU Int 114(1):38–45

    PubMed  Google Scholar 

  36. Loeb S et al (2008) Progression after radical prostatectomy for men in their thirties compared to older men. BJU Int 101(12):1503–1506

    PubMed  PubMed Central  Google Scholar 

  37. Magheli A et al (2007) Impact of patient age on biochemical recurrence rates following radical prostatectomy. J Urol 178(5):1933–1937 (discussion 1937–8)

    PubMed  Google Scholar 

  38. Siddiqui SA et al (2006) Impact of patient age at treatment on outcome following radical retropubic prostatectomy for prostate cancer. J Urol 175(3 Pt 1):952–957

    PubMed  Google Scholar 

  39. Twiss C, Slova D, Lepor H (2005) Outcomes for men younger than 50 years undergoing radical prostatectomy. Urology 66(1):141–146

    PubMed  Google Scholar 

  40. Freedland SJ et al (2004) Do younger men have better biochemical outcomes after radical prostatectomy? Urology 63(3):518–522

    PubMed  Google Scholar 

  41. Khan MA et al (2003) Long-term cancer control of radical prostatectomy in men younger than 50 years of age: update 2003. Urology 62(1):86–91 (discussion 91–2)

    PubMed  Google Scholar 

  42. Droz JP et al (2010) Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int 106(4):462–469

    PubMed  PubMed Central  Google Scholar 

  43. Alibhai SM et al (2004) Is there age bias in the treatment of localized prostate carcinoma? Cancer 100(1):72–81

    PubMed  Google Scholar 

  44. Potosky AL et al (2004) Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 96(18):1358–1367

    PubMed  Google Scholar 

  45. Cooperberg MR, Broering JM, Carroll PR (2010) Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol 28(7):1117–1123

    PubMed  PubMed Central  Google Scholar 

  46. Sidana A et al (2012) Treatment decision-making for localized prostate cancer: what younger men choose and why. Prostate 72(1):58–64

    PubMed  Google Scholar 

Download references

Acknowledgements

We would like to extend our gratitude to all staff who are involved in building and maintaining SGH Prostate Cancer Registry for their hard work and dedication.

Author information

Authors and Affiliations

Authors

Contributions

All three authors contributed in study conception and design. YL and HHH contributed in data acquisition, data analysis, statistical analysis and interpretation. YL also contributed in drafting and revision of the manuscript. WKOL contributed in critical revision of the manuscript for important intellectual content as well as provided overall supervision of the study. All authors discussed the results and approved the final manuscript.

Corresponding author

Correspondence to Yadong Lu.

Ethics declarations

Conflict of interest

The author(s) declare that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lu, Y., Huang, H.H. & Lau, W.K.O. Survival outcomes of Asian younger men (< 55 years) undergoing radical prostatectomy: a review of prostate cancer database in a tertiary hospital in Singapore. Int Urol Nephrol 52, 1885–1891 (2020). https://doi.org/10.1007/s11255-020-02518-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-020-02518-7

Keywords

Navigation