Patients aged 60 years or younger who have low-risk prostate cancer (PCa) are no more likely than their older counterparts to experience progression while on active surveillance (AS), investigators reported at the 34th Annual European Association of Urology Congress in Barcelona, Spain.
Marco Bandini, MD, of Vita-Salute University San Raffaele in Milan, Italy, and collaborators evaluated 296 patients with low-risk PCa who were enrolled in an AS program from 2012 to 2018 at a single tertiary referral center. The investigators defined low-risk PCa according to D’Amico criteria (PSA level below 10 ng/mL, clinical stage T2a or less, Gleason score of 6). They divided patients into 2 groups based on their age at diagnosis: those aged 60 years or less (95 patients) or those older than 60 years (201 patients).
Multivariable analysis revealed no significant difference between the age groups in the risk of biopsy-based Gleason score upgrading.
In addition, Dr Bandini’s team examined pathologic outcomes of patients who underwent radical prostatectomy (RP) upon disease progression. This group included 30 patients (66.7%) in the younger group and 36 (47%) in the older group. A significantly smaller proportion of younger patients than older patients had unfavorable pathologic characteristics (Gleason score of 4+3 or higher, pN1, or pathologic stage pT3 or higher) at RP (24.2% vs 51.2%), according to the investigators.
Bandini M, Scarcella S, Suardi N, et al. Young men with low risk prostate cancer can be safely candidate to active surveillance regardless of the extent of biopsy involvement: Results from a single center series with pathological confirmation. Presented at the 34th Annual European Association of Urology Congress in Barcelona, Spain, March 15 to 19. Poster 465