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

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.

Automated summary

Metastatic prostate cancer (mPCa) rarely occurs in individuals under 60 years old. This study found that younger mPCa patients have earlier biochemical recurrence and significantly reduced overall survival compared to older patients. Special caution is necessary when treating these younger mPCa patients.