Prostate cancer in younger patients: Does it make a difference in oncological outcomes?
PO-1502
Abstract
Prostate cancer in younger patients: Does it make a difference in oncological outcomes?
Authors: Nejla Fourati1, Mariem Frikha2, Syrine Zouari1, Fatma Dhouib1, Wicem Siala1, Leila Farhat1, Wafa Mnejja1, Jamel Daoud1
1Habib Bourguiba Hospital Faculty of Medicine University of Sfax, Radiotherapy Department, Sfax, Tunisia; 2Habib Bourguiba Hospital Faculty of Medicine University of Sfax, Radiotherapy Department , Sfax, Tunisia
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Purpose or Objective
Prostate cancer is considered a disease of older men, but today over 10% of new diagnoses occur in men aged ≤ 65 years. The forms of younger patients are considered more aggressive, but the literature does not adequately explore the data for this patient population. Our retrospective study aimed to compare the prognosis of prostate cancer in the young patient group to the common population.
Material and Methods
From November 2011 to January 2019, 181 patients were treated with conformal radiotherapy, with or without hormonotherapy, for prostate cancer including 42 patients aged ≤ 65 years (23.2%) (Group 1). The second group included 94 patients aged between 65 and 75 years.
Overall survival (OS) was calculated from histological diagnosis to the date of death or the date of last information. Biochemical recurrence-free survival (BRFS) was calculated from the end of radiotherapy to the date of biochemical relapse or the date of last information. The Event-free survival (EFS) was calculated from the end of radiotherapy to the date of the specific event (specific death, clinical or radiological or biochemical relapse) or the date of last information. Survival analysis was made according to the Kaplan-Meier method. Log-rank test was used to compare the survivals of the 2 groups.
Results
For group 1, the median radiotherapy dose was 76 Gy [70-78] was delivered. According to the NCCN classification: 3 patients (6.1%) had a low risk, 9 patients (18.3%) had an intermediate risk, 21 patients (42.8%) had a high risk, 10 patients (20.4%) had a very high risk, and 6 patients (12.2%) were metastatic. Radiotherapy was associated with hormonotherapy for 46 patients (93.8%): 7 patients (15.2%) for the short term and 39 patients (84.8%) for the long term. Prophylactic lymph node irradiation was given to 10 patients (20.4%) and curative irradiation to one patient (2%).
For group 2, the median radiotherapy dose of 76 Gy [70-78] was delivered. According to the NCCN classification: 4 patients (4.2%) had a low risk, 56 patients (59.57%) had an intermediate risk, 37 patients (39.36%) had a high risk and 16 patients (17%) had a very high risk and 14 patients (14.89%) had metastatic disease. In this group,88 patients (93.6%) had HT for 21 patients (23.8%) in a short time and 67 patients (76.13%) in a long time. Node irradiation was given prophylactically in 26 patients (27.6%) and curatively in 6 patients (6.38%).
The OS rates at 5 and 10 years were 93.7% and 78.7% for G 1 versus 92.7% and 56% for G 2 (p=0.9). The BRFS rates at 5 and 10 years were 77.7% and 77.7% for G 1 versus 83% and 80.1% for G 2 (p=0.7). The EFS rates at 5 and 10 years were 72.1% and 72.1% for G 1 versus 80.6% and 77.8% for G 2 (p=0.4).
Conclusion
In our series, prostate cancer in young patients < 65 years does not appear to be more aggressive than that in older patients (65-75 years). all survival parameters were comparable between the 2 groups suggesting an evolutionary similarity between the 2 entities.