J Cancer 2021; 12(16):4985-4992. doi:10.7150/jca.58144

Research Paper

Reduced survival of young patients under 55 years with metastatic prostate cancer: a population-based study

Pan Song1*, Zhufeng Peng1*, Mengxuan Shu2*, Jiaxiang Wang2, Peiwen Liu2, Xiaoyu Di3, Luchen Yang1, Zhenhuan Liu1, Jing Zhou1, Qiang Dong1✉

1. Department of Urology, West China Hospital of Sichuan University, Chengdu, 610000, Sichuan Province, China.
2. The first Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
3. The second Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
*These authors contributed equally to this study.

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Citation:
Song P, Peng Z, Shu M, Wang J, Liu P, Di X, Yang L, Liu Z, Zhou J, Dong Q. Reduced survival of young patients under 55 years with metastatic prostate cancer: a population-based study. J Cancer 2021; 12(16):4985-4992. doi:10.7150/jca.58144. Available from https://www.jcancer.org/v12p4985.htm

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Abstract

Objective: The aim of this study was to evaluate the prognosis of patients with metastatic prostate cancer (mPCa) in different age groups.

Methods: Patients with mPCa from 2004 to 2016 in the Surveillance, Epidemiology and End Results (SEER) database were identified. Seven groups were divided according to the age at diagnosis, including ≤55 years, 56-60 years, 61-65 years, 66-70 years, 71-75 years, 76-80 years and >80 years. Fine and Gray's competing risks model and Kaplan-Meier analysis were conducted to evaluate the cancer-specific survival (CSS).

Results: A total of 36231 patients with mPCa were included. The CSS curves of the overall cohort showed that patients aged 55 years had significantly worse CSS than patients in age groups of 56-60 [HR:0.93 (0.87~1.00), p=0.039], 61-65 [HR:0.91 (0.85~0.97), p=0.003] and 66-70 [HR:0.90 (0.84~0.96), p=0.001]. After removing patients dead for other reasons, the differences of CSS curves between ≤55 years group and 56-70 years groups were not significant. However, the mean survival time of ≤55 years group (55.78±2.48 months) was still shorter than 56-60 years (57.28±2.35 months), 61-65 years (57.64±2.07 months), and 66-70 years (57.11±2.11 months). When stratified by M stages, similar results were found in M1a, M1b and M1c stage groups. According to Fine-Gray competing risks models, patient ≤55 years featured significantly higher sub-distribution hazard ratio (sdHR) than 61-65 years group [sdHR: 0.94(0.88~1.00); p=0.046].

Conclusions: The mPCa patients ≤55 years seemed to be associated with worse prognosis in comparison with patients aging 56-70 years.

Keywords: metastatic prostate cancer, young patients, prognosis, SEER