Positive outcomes seen in prostatectomy-treated younger men with prostate cancer
Additional evidence suggests that younger men with prostate cancer who are treated with radical prostatectomy mostly have favourable disease characteristics and outcomes.
Researchers evaluated the histopathological features and associated clinical behaviour of prostate cancer in a cohort of younger men (n=171; median age 43 years; range, 38 to 49 years) treated with radical prostatectomy at an academic institution between 2001 and 2015. A comprehensive pathology review was performed.
The authors collected clinical and follow-up data from a prospectively maintained institutional database.
Forty-two percent of the tumours were Gleason score 3+3 and 45 percent were 3+4. On the other hand, 10.5, 0.5 and 1.0 percent of tumours were Gleason score 4+3, 4+4 and 4+5, respectively.
There were 11 cases (6 percent) of mucinous carcinoma (>25 percent extracellular mucin), an uncommon histological variant which comprises 0.2 percent of prostate cancers. Furthermore, 21 cases (12 percent) of acinar adenocarcinoma had a <25 percent mucinous component.
A total of 156 men (91 percent) had available follow-up data. Twelve patients (19 percent) developed biochemical recurrence, but there was no documented postoperative metastasis or death from disease in the cohort.
All cases of mucinous carcinoma were likely to have favourable clinicopathological characteristics.
“While the histopathological features in our series were generally comparable to those of older onset carcinoma, our cohort was enriched for tumours with a mucinous phenotype,” researchers said. “Correlation with molecular-genetic analysis in this subset of tumors may be valuable.”
Prostate cancer is mostly a disease of older men, but younger men with the disease remain a significant clinical subgroup that has not been sufficiently explored, researchers noted.