Clinicopathological Analysis of Prostate Cancer in Young Men: Experience of a Tertiary Referral Hospital in Western Romania.

Background and Objectives: Prostate cancer (PC) has traditionally been regarded as a disease of older men, most commonly diagnosed after the age of 70 years. Recent epidemiological data indicate an increasing incidence of this malignancy among men younger than 55 years, with important clinical and therapeutic implications. The present study aimed to analyze the epidemiological, clinical, and pathological characteristics of PC in young patients diagnosed at a tertiary referral urology center in western Romania. Materials and Methods: Medical records and the electronic database of the "Pius Brînzeu" County Emergency Clinical Hospital in Timișoara (PBCECHT) were reviewed to identify men aged ≤55 years diagnosed with PC over a 10-year period (2015-2024). Collected data included: the age at diagnosis, serum prostate-specific antigen (PSA) levels, specimen type, histologic type, Gleason score/International Society of Urological Pathology (ISUP) grade group, tumor stage, and additional prognostic factors. Results: Of the 1742 patients diagnosed with PC during the study period, 70 (4.02%) were aged ≤55 years. The average age at diagnosis for the group of young men was 52.47 years. Most patients were from urban areas (64.29%). The PSA was available in 51/70 cases (range: 1.35-5182; median: 15; IQR: 51). The mean Gleason score was 7.15, and the mean ISUP grade group was 2.5. Histologically, acinar adenocarcinoma predominated, while a minority of cases showed mixed acinar and ductal/adenocarcinomas with ductal features. Most tumors (70%) were clinically significant. Conclusions: Although less common, PC in young men often exhibits aggressive features. It is crucial to consider genetic risk factors and a multidisciplinary approach for optimal management.