Among men under the age of 60, treatment of localized prostate cancer with radical prostatectomy alone resulted in prolonged cancer-free survival for a majority of men. These results were published in the journal Urology.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.

Men who are diagnosed with prostate cancer at a young age are likely to live for many years after their diagnosis. As a result, reducing the likelihood of cancer recurrence may be particularly important for these men. Furthermore, it’s possible that age at diagnosis could influence prognosis, and that the effectiveness of specific treatments could vary by age.

To confirm that radical prostatectomy (surgical removal of the prostate) effectively treats localized prostate cancer in young men, researchers evaluated outcomes among 291 patients under the age of 60. The men had been treated for prostate cancer at the MD Anderson Cancer Center in Texas between 1988 and 1998. Surgery found that 72% of the men had cancer confined to the prostate.

The study evaluated the frequency of “biochemical failure” after radical prostatectomy. Biochemical failure refers to a rise in blood serum levels of prostate-specific antigen (PSA) that could suggest that cancer is coming back. Men who had detectable PSA (any level greater than 0.01 ng/mL) during follow-up were classified as having a biochemical failure.

  • Nineteen out of 291 men (7%) experienced a biochemical failure (detectable PSA rise during follow-up).
  • Patients were more likely to experience a biochemical failure if they had higher initial PSA (greater than 10 ng/mL); a biopsy Gleason score of greater than 7; or cancer that had spread beyond the prostate.
  • Among men who experienced a biochemical failure, the median time between surgery and detection of PSA was just over four years.
  • Overall, the probability of surviving without detectable PSA was 99% at one year after surgery, 91% at five years after surgery, and 91% at seven years after surgery.

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The researchers conclude that surgical treatment of prostate cancer in men under the age of 60 results in excellent survival and low risk of recurrence.

Reference: Rosser CJ, Kamat AM, Wang X et al. Biochemical Disease-Free Survival in Men Younger Than 60 Years with Prostate Cancer Treated with Radical Prostatectomy. Urology. 2006;67:769-773.

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