Abstract

Aim: Approximately 10% of men are diagnosed with prostate cancer in their lifetime. Its frequency generally increases with age and is known as old man's disease. This is due to longer exposure to andogen with advancing age. In young patients, the duration of exposure to this androgen is shorter. This study aimed to examine the survival times of the patient population under the age of sixty-five with metastatic prostate cancer who used enzatulamide and abiraterone.

Method: In this study, patients under the age of sixty-five who were followed up and treated in our hospital were diagnosed with prostate cancer. Patients using enzatulamide or abiraterone for metastatic disease and without a second malignancy were included. The diagnosis date and death dates required to calculate the demographic data and survival times of the patients were obtained from the hospital registration system and death notification system. Kaplan Meier and Log-rank tests were used in the survival findings of the patients.

Results: A total of 40 patients were included in the study. The average age was found to be 58 years. Gleason score of 87.5% of the patients was 7 and above. 82.5% of the patients had de-novo metastatic disease and the rate of patients with visceral organ metastases was 27.5%. 42.5% of the patients used docetaxel before using enzatulamide and abiraterone. 62.5% of the patients used enzatulamide, while the rest used abiraterone. The mean progression-free survival time after treatment in the general population was 20.7 months, while the overall survival time was 29.3 months. In the group using abiraterone, the progression-free survival time was better than the group using enzatulamide, 22.2 months vs. 18.7 months, and the overall survival time was better, 32.5 months vs. 27.8 months. It was observed that the use of abiraterone and enzatulamide in the first step had an advantage of approximately 4.5 months of progression-free survival and 4.8 months of overall survival compared to their use in later stages.

Conclusion: In metastatic prostate cancer under the age of sixty-five, the use of enzatulamide or abiraterone in the first step has a survival advantage compared to use in later stages. Although most clinicians prefer enzatulamide to avoid the use of steroids in young patients, the use of abiraterone may be a good option in the patient group under the age of sixty-five.

Keywords: Metastatic prostat cancer, Enzatulamid, Abirateron