Is the Prognosis of Primary Metastatic Carcinoma of the Prostate in Younger Men Really Worse than that in Older Men ?

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To investigate the prognosis and predictive factors of primary metastatic prostate carcinoma (M1CaP) in men younger than 60 years. Methods : From April 1986 to December 1999, 18 patients with M1CaP were enrolled. Cause-specific and progression-free surival rates were estimated using the Kaplan-Meier method and compared with those of patients aged over 60 years with M1CaP in the same time period. Results : The 5-and 10-year cause-specific survival rates were 33.7% and 0%, respectively, in the younger men compared with 57.1% and 41.9%, respectively, in the older age group (p<0.001). In multivariate analysis using Cox's proportional hazards model for cause-specific survival, pretreatment serum PSAwas the only significant predictor (p<0.02). Conclusions : The prognosis of M1CaP in men younger than 60 is worse than for those aged over 60. Therefore, it is necessary to use a combination therapy (e. g. hormonal plus chemotherapy) for these patients.