title: Prognostic impact of young age on stage IV prostate cancer treated with primary androgen deprivation therapy.
abstract: OBJECTIVE
  To elucidate whether the disease characteristics and prognosis of stage IV prostate cancer treated with primary androgen deprivation therapy differ between young and elderly patients.
  
  
  METHODS
  A total of 3006 patients identified from the database of the Japan Study Group of Prostate Cancer were included in the analysis according to the following entry criteria: age of 75 years or less and stage IV disease. These patients were stratified into three groups: young (aged ≤ 55 years); middle-aged (aged ≧ 56 and ≤ 65 years); and elderly (aged ≧ 66 and ≤ 75 years). Their prognoses were analyzed both within age groups and according to whether or not there was metastasis.
  
  
  RESULTS
  The proportion of lymph node metastasis was significantly higher in the young group than in the elderly group (P = 0.007), and there were no significant differences in other factors among age groups. The overall survival rate at 5 years in the young group was significantly worse than that in the middle-aged and elderly groups (26.6%, 59.7% and 55.3%, respectively) in patients with stage IV disease with metastasis, although there was no difference among age groups in patients with stage IV disease without metastasis. Multivariate analysis showed that younger age was an independent strong prognostic factor in stage IV disease with metastasis.
  
  
  CONCLUSIONS
  Young men with metastatic prostate cancer have a poor prognosis. Young age is an independent prognostic factor in stage IV metastatic prostate cancer patients treated with primary androgen deprivation therapy.
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kimura
authors.forename: Mizuki
authors.initials: M
authors.lastname: Onozawa
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.forename: Taeko
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Akira
authors.initials: A
authors.lastname: Joraku
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Shiro
authors.initials: S
authors.lastname: Hinotsu
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D000726:Androgen Antagonists
keywords: primary androgen deprivation therapy; prostate cancer; stage IV; young men