Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;41(2):421-425.
doi: 10.1007/s00345-023-04287-1. Epub 2023 Jan 19.

Histopathological results of radical prostatectomy specimen of men younger than 50 years of age at the time of surgery: possible implications for prostate cancer screening programs?

Gisa Mehring  1 , Derya Tilki  1   2 , Hans Heinzer  1 , Thomas Steuber  1   2 , Randi M Pose  1 , Imke Thederan  1 , Lars Budäus  1 , Georg Salomon  1 , Alexander Haese  1 , Uwe Michl  1 , Tobias Maurer  1   2 , Hartwig Huland  1 , Markus Graefen  1 , Hendrik Isbarn  3
Affiliations

Histopathological results of radical prostatectomy specimen of men younger than 50 years of age at the time of surgery: possible implications for prostate cancer screening programs?

Gisa Mehring et al. World J Urol. 2023 Feb.

Abstract

Introduction: Prostate cancer (PCa) detection is usually achieved by PSA measurement and, if indicated, further diagnostics. The recent EAU guidelines recommend a first PSA test at the age of 50 years, if no family history of PCa or BRCA2 mutation exists. However, some men might harbor significant PCa at younger age; thus we evaluated the histopathological results of men treated with radical prostatectomy (RP) in their 40 s at our institution.

Materials and methods: We relied on the data of all patients who underwent RP in our institution between 1992 and 2020 and were younger than 50 years at the time of surgery. The histopathological results are descriptively presented. Moreover, we tested the effect of a positive family history on the descriptive results.

Results: Overall, 1225 patients younger than 50 years underwent RP at our institution. Median age was 47 years. Most patients showed favorable histopathological characteristics. However, 20% of patients had extraprostatic disease (≥ pT3a), 15% had ISUP Gleason grade group ≥ 3, and 7% had positive lymph nodes (pN1). Patients with a known positive family history did not have a higher rate of adverse disease as their counterparts with a negative family history.

Discussion: Our data show that the majority of patients who were diagnosed with PCa at a very young age had favorable histopathological RP characteristics. However, a non-negligible proportion of patients already showed locally advanced disease and would have probably benefited from earlier PCa detection. This should be kept in mind when PCa screening recommendations are proposed.

Keywords: Prostate cancer; Radical prostatectomy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Proportion of patients treated with radical prostatectomy between 1992 and 2020, 49 years or younger at surgery. The Y-axis represents the proportion of men in percent in relation to all patients who underwent radical prostatectomy. The X-axis refers to the respective year of surgery
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Hugosson J, Carlsson S, Aus G, Bergdahl S, Khatami A, Lodding P, et al. Mortality results from the Goteborg randomised population-based prostate-cancer screening trial. Lancet Oncol. 2010;11(8):725–732. doi: 10.1016/S1470-2045(10)70146-7. - DOI - PMC - PubMed
    1. Schroder FH, Hugosson J, Roobol MJ, Tammela TLJ, Zappa M, Nelen V, et al. Screening and prostate cancer mortality: results of the European randomised study of screening for prostate cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384(9959):2027–2035. doi: 10.1016/S0140-6736(14)60525-0. - DOI - PMC - PubMed
    1. Shoag JE, Mittal S, Hu JC. Reevaluating PSA testing rates in the PLCO trial. New Engl J Med. 2016;374(18):1795–1796. doi: 10.1056/NEJMc1515131. - DOI - PubMed
    1. Mahal BA, Aizer AA, Efstathiou JA, Nguyen PL. Association of very low prostate-specific antigen levels with increased cancer-specific death in men with high-grade prostate cancer. Cancer-Am Cancer Soc. 2016;122(1):78–83. - PubMed
    1. Carlsson S, Assel M, Ulmert D, Gerdtsson A, Hugosson J, Vickers A, et al. Screening for prostate cancer starting at age 50–54 years a population-based cohort study. Eur Urol. 2017;71(1):46–52. doi: 10.1016/j.eururo.2016.03.026. - DOI - PMC - PubMed

Substances