中文摘要：

目的探讨72例≤59岁前列腺癌患者临床及病理特点、生存率和影响预后的因素。方法2000年1月至2011年10月天津医科大学附属天津肿瘤医院收治前列腺癌患者566例，≤59岁前列腺癌72例（12．7％），具备完整临床病理资料。中位随访时间25个月（1—108个月），中位年龄55岁（16—59岁）。临床分期Ⅱ期4例（5．5％）、Ⅲ期12例（16．7％）、IV期56例（77．8％）。观察无进展生存率（PFS）、总生存率（OS），分析临床特点及影响预后的因素。结果病理类型腺癌占86．1％（62／72），Gleason评分8-10分占69．1％（29／42）；特殊类型癌占13．9％（10／72）。内分泌治疗后，经中位12个月进展为雄激素非依赖性前列腺癌。中位无进展生存期13个月，1、3、5年PFS分别为53．8％、12．1％和6．1％；中位生存期39．6个月，1、3、5年OS分别为85．2％、58．8％和15．6％。单因素分析显示，年龄、基线PSA、病理类型、肿瘤分期和是否局部治疗是影响预后因素；多因素分析显示，病理类型是影响预后的独立因素。结论我国≤59岁前列腺癌临床易漏、误诊，病理类型复杂，恶性程度较高，以局部治疗为主的综合治疗是有效治疗手段。

英文摘要：

Objective To explore the clinicopathological characteristics and prognostic factors in prostate cancer patients under 59 years of age. Methods From January 2000 to October 2011, 566 prostate cancer patients underwent treatments. Among them, 72 （ 12.7% ） patients under 59 years of age with the integrated clinical data were reviewed. The median follow-up period was 25 months （range：l - 108） and the median age 55 years （range：16 -59）. Four （5.5%） cases had the clinical stage of I[ , 12（16. 7% ） cases of stage II1 and 56（77.8% ） cases of stage IV. Progression-free survival （PFS）, overall survival （OS） and prognostic factors were analyzed. Results The rate of adenocarcinoma was 86. 1% （ 62/72 ） and the Gleason score of 8 -10 69. 1% （29/42）. Special type carcinoma accounted for 13.9% （10/72）. The median time to androgen-independent prostate cancer （AIPC） was 12 months after endocrine therapy. The 1-, 3- and 5-year PFS were 53.8% , 12. 1% and 6. 1% and those for OS 85.2% , 58. 8% and 15.6% respectively. The prognostic factors were age, baseline prostate special antigen （PSA）, types of pathology, tumor stage and local treatment by univariate analysis. The type of pathology was an independent prognostic factor of affecting significantly the prognosis by multivariate analysis. Conclusion Prostate cancer patients under 59 years of age are characterized by misdiagnosis, complexity of pathology and high malignancy. Comprehensive regiment with predominant local therapy is an effective approach.