Premium
Functional and oncological outcomes of patients aged <50 years treated with radical prostatectomy for localised prostate cancer in a E uropean population
Author(s) -
Becker Andreas,
Tennstedt Pierre,
Hansen Jens,
Trinh QuocDien,
Kluth Luis,
Atassi Nabil,
Schlomm Thorsten,
Salomon Georg,
Haese Alexander,
Budaeus Lars,
Michl Uwe,
Heinzer Hans,
Huland Hartwig,
Graefen Markus,
Steuber Thomas
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12407
Subject(s) - medicine , prostate cancer , prostatectomy , urology , hazard ratio , biochemical recurrence , confidence interval , erectile dysfunction , population , urinary continence , cancer , gynecology , environmental health
Objective To address the biochemical and functional outcomes after radical prostatectomy ( RP ) of men aged <50 years in a large E uropean population.Patients and Methods Among 13 268 patients who underwent RP for clinically localised prostate cancer at our centre (1992–2011), 443 (3.3%) men aged <50 were identified. Biochemical recurrence ( BCR ) and functional outcomes (International Index of Erectile Function [ IIEF ‐5], use of pads), were prospectively evaluated and compared between men aged <50 years and older patients.Results Men aged <50 years were more likely to harbour D ’ A mico low‐risk (49.4 vs 34.9%, P < 0.001), organ‐confined (82.6 vs 69.4%, P < 0.001) and low‐grade tumours ( G leason score <7: 33.1 vs 28.7%, P < 0.001). Multivariate C ox regression analysis showed that age <50 years (hazard ratio 0.99; confidence interval 0.72–1.31; P = 0.9) was not a predictor of BCR . Urinary continence was more favourable in younger patients, resulting in continence rates of 97.4% vs 91.6% in most recent years (2009–2011) for patients aged <50 vs ≥50 years. After RP , a median IIEF ‐5 drop of 4 points in younger men vs 8 points in older patients was recorded ( P < 0.001). Favourable recovery of urinary continence and erectile function in patients aged <50 years compared with their older counterparts was confirmed after multivariable adjustment.Conclusion Men aged <50 years diagnosed with localised prostate cancer should not be discouraged from RP , as the postoperative rates of urinary incontinence and erectile dysfunction are low and probability of BCR ‐free survival at 2 and 5 years is high.