Functional and oncological outcomes of patients aged <50 years treated with radical prostatectomy for localised prostate cancer in a European population. (2nd December 2013)

• Record Type: Journal Article
• Authors: Becker, Andreas; Tennstedt, Pierre; Hansen, Jens; Trinh, Quoc‐Dien; Kluth, Luis; Atassi, Nabil; Schlomm, Thorsten; Salomon, Georg; Haese, Alexander; Budaeus, Lars; Michl, Uwe; Heinzer, Hans; Huland, Hartwig; Graefen, Markus; Steuber, Thomas
• Is Part Of: BJU international. Volume 114:Number 1(2014:Jul.)
• Page Start: 38
• Page End: 45
• Publication Date: 2013-12-02
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12407
• Languages: English
• ISSNs: 1464-4096

Abstract

&lt;abstract abstract-type=&quot;main&quot;&gt; &lt;title&gt; &lt;x xml:space=&quot;preserve&quot;&gt;Abstract&lt;/x&gt; &lt;/title&gt; &lt;sec id=&quot;bju12407-sec-0001&quot; sec-type=&quot;section&quot;&gt; &lt;title&gt;Objective&lt;/title&gt; &lt;p&gt; &lt;list id=&quot;bju12407-list-0001&quot; list-type=&quot;bullet&quot;&gt; &lt;list-item&gt; &lt;p&gt;To address the biochemical and functional outcomes after radical prostatectomy (RP) of men aged &amp;lt;50 years in a large European population.&lt;/p&gt; &lt;/list-item&gt; &lt;/list&gt; &lt;/p&gt; &lt;/sec&gt; &lt;sec id=&quot;bju12407-sec-0002&quot; sec-type=&quot;section&quot;&gt; &lt;title&gt;Patients and Methods&lt;/title&gt; &lt;p&gt; &lt;list id=&quot;bju12407-list-0002&quot; list-type=&quot;bullet&quot;&gt; &lt;list-item&gt; &lt;p&gt;Among 13 268 patients who underwent RP for clinically localised prostate cancer at our centre (1992–2011), 443 (3.3%) men aged &amp;lt;50 were identified.&lt;/p&gt; &lt;/list-item&gt; &lt;list-item&gt; &lt;p&gt;Biochemical recurrence (BCR) and functional outcomes (International Index of Erectile Function [IIEF‐5], use of pads), were prospectively evaluated and compared between men aged &amp;lt;50 years and older patients.&lt;/p&gt; &lt;/list-item&gt; &lt;/list&gt; &lt;/p&gt; &lt;/sec&gt; &lt;sec id=&quot;bju12407-sec-0003&quot; sec-type=&quot;section&quot;&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt; &lt;list id=&quot;bju12407-list-0003&quot; list-type=&quot;bullet&quot;&gt; &lt;list-item&gt; &lt;p&gt;Men aged &amp;lt;50 years were more likely to harbour D&#39;Amico low‐risk (49.4 vs 34.9%, &lt;italic&gt;P&lt;/italic&gt; &amp;lt; 0.001), organ‐confined (82.6 vs 69.4%, &lt;italic&gt;P&lt;/italic&gt; &amp;lt; 0.001) and low‐grade tumours (Gleason score &amp;lt;7: 33.1 vs 28.7%, &lt;italic&gt;P&lt;/italic&gt; &amp;lt; 0.001).&lt;/p&gt; &lt;/list-item&gt; &lt;list-item&gt; &lt;p&gt;Multivariate Cox regression analysis showed that age &amp;lt;50 years (hazard ratio 0.99; confidence interval 0.72–1.31; &lt;italic&gt;P&lt;/italic&gt; = 0.9) was not a predictor of BCR.&lt;/p&gt; &lt;/list-item&gt; &lt;list-item&gt; &lt;p&gt;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 &amp;lt;50 vs ≥50 years.&lt;/p&gt; &lt;/list-item&gt; &lt;list-item&gt; &lt;p&gt;After RP, a median IIEF‐5 drop of 4 points in younger men vs 8 points in older patients was recorded (&lt;italic&gt;P&lt;/italic&gt; &amp;lt; 0.001).&lt;/p&gt; &lt;/list-item&gt; &lt;list-item&gt; &lt;p&gt;Favourable recovery of urinary continence and erectile function in patients aged &amp;lt;50 years compared with their older counterparts was confirmed after multivariable adjustment.&lt;/p&gt; &lt;/list-item&gt; &lt;/list&gt; &lt;/p&gt; &lt;/sec&gt; &lt;sec id=&quot;bju12407-sec-0004&quot; sec-type=&quot;section&quot;&gt; &lt;title&gt;Conclusion&lt;/title&gt; &lt;p&gt; &lt;list id=&quot;bju12407-list-0004&quot; list-type=&quot;bullet&quot;&gt; &lt;list-item&gt; &lt;p&gt;Men aged &amp;lt;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.&lt;/p&gt; &lt;/list-item&gt; &lt;/list&gt; &lt;/p&gt; &lt;/sec&gt; &lt;/abstract&gt;