CLINICAL COURSE OF EARLY-ONSET PROSTATE-CANCER WITH SPECIAL REFERENCETO FAMILY HISTORY AS A PROGNOSTIC FACTOR

Objective: The aim of this study was to describe the clinical characte ristics of early onset prostate cancer, with special reference to fami ly history as a possible prognostic factor. Material and Methods: We i dentified all cases of prostate cancer diagnosed before the age of 51 in the Southern health care region in Sweden between 1958 and 1994. Cl inical data were collected retrospectively from medical records. Data about family history of prostate cancer were also collected from the p arish authorities and the Regional Cancer Registry. Results: In all, 8 9 cases were included. The median time of follow-up was 17 years. Duri ng the time of follow-up, 65 patients died, 57 of whom died from prost ate cancer. At diagnosis, 34% of the patients had localized, 22% had l ocallly advanced, and 40% had metastatic tumours. The tumours were wel l differentiated in 30% of the cases, moderately differentiated in 38% , and poorly differentiated in 28%. Information on tumour grade and st age was missing in 3 cases. The cause-specific survival was 48% at 5 y ears and 29% at 10 years. The 18 patients with a family history of pro state cancer had a somewhat better prognosis than the patients with a negative family history, though the difference did not reach statistic al significance (p = 0.08). Conclusions: Early onset prostate cancer i s a serious disease with high mortality. The proportions of patients w ith poorly differentiated and metastatic tumours appeared to be larger than for cases diagnosed later in life, but this could be explained b y selection bias since younger men may have a lower probability of hav ing asymptomatic localized tumours diagnosed. Family history of prosta te cancer was not significantly associated with prognosis.