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Prognostic impact of young age on stage IV prostate cancer treated with primary androgen deprivation therapy
Author(s) -
Kimura Tomokazu,
Onozawa Mizuki,
Miyazaki Jun,
Matsuoka Taeko,
Joraku Akira,
Kawai Koji,
Nishiyama Hiroyuki,
Hinotsu Shiro,
Akaza Hideyuki
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12389
Subject(s) - medicine , androgen deprivation therapy , prostate cancer , stage (stratigraphy) , metastasis , androgen , oncology , disease , cancer , young adult , multivariate analysis , prostate , hormone , paleontology , biology
Objectives To elucidate whether the disease characteristics and prognosis of stage IV prostate cancer treated with primary androgen deprivation therapy differ between young and elderly patients. Methods A total of 3006 patients identified from the database of the J apan S tudy G roup of P rostate C ancer were included in the analysis according to the following entry criteria: age of 75 years or less and stage IV disease. These patients were stratified into three groups: young (aged ≤55 years); middle‐aged (aged ≧56 and ≤65 years); and elderly (aged ≧66 and ≤75 years). Their prognoses were analyzed both within age groups and according to whether or not there was metastasis. Results The proportion of lymph node metastasis was significantly higher in the young group than in the elderly group ( P = 0.007), and there were no significant differences in other factors among age groups. The overall survival rate at 5 years in the young group was significantly worse than that in the middle‐aged and elderly groups (26.6%, 59.7% and 55.3%, respectively) in patients with stage IV disease with metastasis, although there was no difference among age groups in patients with stage IV disease without metastasis. Multivariate analysis showed that younger age was an independent strong prognostic factor in stage IV disease with metastasis. Conclusions Young men with metastatic prostate cancer have a poor prognosis. Young age is an independent prognostic factor in stage IV metastatic prostate cancer patients treated with primary androgen deprivation therapy.