[1063] Clinicopathologic Features of Adenocarcinoma of the Prostate in Men 45 Years Old or Younger Treated by Radical Prostatectomy

Jing-Jing Yang, Sara M Falzarano, Karen Streator Smith, Ming Zhou, Eric A Klein, Cristina Magi-Galluzzi. Cleveland Clinic, Cleveland, OH

Background: Prostate cancer is typically a disease of older men, with most cases diagnosed in men older than 50 years. Studies have indicated that tumors diagnosed in younger patients may be associated with unfavorable features. We examined contemporary cases of PCA in men aged 45 years or younger who underwent radical prostatectomy (RP) at our institution.
Design: We queried our radical prostatectomy (RP) database for men diagnosed with PCA from 2000 to 2011. Patients aged 45 years old or younger at the time of RP were included in the study. Race, family history, preoperative and postoperative characteristics were evaluated.
Results: Of the total 4527 men who underwent RP at our institution between 2000 and 2011, 122 (2.7%) were aged 45 years or younger. Patients' median age and preoperative PSA were 44 years (range 36-45), and 4.18 ng/ml (range 0.70-90.80), respectively. Race was recorded for 118 men and distribution was as following: 93 (76%) Whites, 23 (19%) Blacks, and 2 (2%) Hispanics. Positive family history was present in 53 (43%) men: 39 (42%) Whites, 11 (48%) Blacks, 1 (50%) Hispanic, and 2 of unknown race. Biopsy (Bx) Gleason score (GS) was 6 in 92 (76%), 7 in 26 (21%), 8 in 2 (2%), and 9 in 1 (1%). Number of positive Bx cores was <3 in 53 (52%) and ≥3 in 49 (48%) patients. Highest percentage of Bx core involvement was ≤50 in 76 (72%) and >50 in 29 (28%). Eighty-nine (74%) men met the D'Amico criteria for low-risk (LR), 26 (22%) for intermediate-risk (IR) and 5 (4%) for high-risk (HR) disease. RP GS was 6 in 49 (40%), 7 in 67 (55%), ≥8 in 6 (5%). Organ confined (OC) disease was found in 98 (73%) RP specimens: 79 (89%) LR, 18 (69%) IR, and 1 (20%) HR. SVI was present in 5 (4%) cases: 4 HR and 1 IR. Node metastases were detected in 3/46 (6%) cases: 2 HR and 1 IR. Tumor volume was low (<0.5 cc) in 26 (21%), medium (0.5-2-0 cc) in 74 (61%), and extensive (>2.0 cc) in 22 (18%) cases. Margin of resection was positive in 28 (23%) specimens.
Conclusions: Our findings indicate that PCA in men 45 years old or younger tend to present with favorable tumor features and represents potentially curable disease in the majority of case, particularly when meets preoperative low-risk criteria. Family history appears to play an important role in the younger population.
Category: Genitourinary (including renal tumors)

Monday, March 19, 2012 1:00 PM

Poster Session II # 190, Monday Afternoon

 

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