Surgery for High-Risk PCa in Young Men Offers Good Long-Term Survival

In a study of patients aged 59 years or younger, cancer-specific and other-cause mortality rates at 20 years were 13.5% and 19.3%, respectively.
In a study of patients aged 59 years or younger, cancer-specific and other-cause mortality rates at 20 years were 13.5% and 19.3%, respectively.

Long-term survival of young men who undergo radical prostatectomy (RP) for high-risk prostate cancer (PCa) is “highly satisfactory,” researchers concluded.

PCa is the leading cause of death during the first 10 years of post-RP survivorship. After 10 years, patients are more likely to die from other causes, the investigators reported online ahead of print in Urologic Oncology. Consequently, surgery should be considered for young patients with high-risk disease, with strict PCa follow-up during the first 10 years of survivorship after RP, the researchers stated.

In a study of 600 men aged 59 years or younger, Paolo Dell'Oglio, MD, of the Urological Research Institute, IRCCS Ospedale San Raffele, Milan, Italy, and colleagues found that the 10-, 15-, and 20 year cancer-specific mortality (CSM) rates were 11.6%, 15.5%, and 13.5%, respectively. The 10-, 15-, and 20-year other-cause mortality (OCM) rates were 5.5%, 13.5%, and 19.3% respectively.

In addition, Dr. Dell'Oglio's team determined that the 5-year probability of CSM and OCM among patients who survived 5, 10, and 15 years after surgery was 6.4% and 2.7% versus 4.6% and 9.6% versus 4.2% and 8.2%, respectively.

Major determinants of CSM included year of surgery, pathologic stage and Gleason score, surgical margin status, and lymph node invasion, the researchers reported.

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