Biochemical disease-free survival in men younger than 60 years with prostate cancer treated with radical prostatectomy

Objectives: To determine the biochemical disease-free survival rates in patients 60 years old or younger who were treated with surgery for localized prostate cancer. Methods: We reviewed the medical records of 291 patients 60 years old or younger who had undergone radical prostatectomy as the sole primary treatment for prostate cancer. Follow-up prostate-specific antigen (PSA) levels were measured 6 to 8 weeks after surgery and 4 to 6 months thereafter. Biochemical failure was defined as a detectable PSA level (greater than 0.01 ng/mL). The median follow-up of the entire study group was 50 months. Results: Eighty-one percent of the patients presented with a serum PSA level of 10 ng/mL or less, and 52% had a Gleason score of less than 7 on prostate biopsy. The radical prostatectomy specimens showed organ-confined disease in 72% of patients, and 83% of tumors had a Gleason score of 7. The 1, 5, and 7-year biochemical disease-free survival rate was 99%, 91%, and 91%, respectively. The fitted multivariate Cox proportional hazards model showed that having a prostatectomy specimen Gleason score greater than 7 or seminal vesicle invasion or nodal disease significantly increased the risk of biochemical failure. Conclusions: In the PSA era, men with prostate cancer who are 60 years old or younger and treated with surgery have an excellent biochemical disease-free outcome.