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749 Pathological and oncological outcomes of elderly men with clinically localized prostate cancer
749
Pathological and oncological outcomes of elderly men with clinically localized prostate cancer Eur Urol Suppl 2014;13;e749
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Mitsuzuka K. 1 , Koie T.2 , Narita S. 3 , Kaiho Y. 1 , Yoneyama T.2 , Tsuchiya N.3 , Kawamura S. 4 , Tochigi T.4 , Ohyama C.2 , Habuchi T.3 , Arai Y. 1 , Michinoku Japan Urological Cancer Study Group, Sendai, Japan 1 Tohoku
University Of Medical School, Dept. of Urology, Sendai, Japan, 2 Hirosaki University of Medical School, Dept. of Urology, Hirosaki,
Japan, 3 Akita University of Medical School, Dept. of Urology, Akita, Japan, 4 Miyagi Cancer Center, Dept. of Urology, Natori, Japan INTRODUCTION & OBJECTIVES: Radical prostatectomy for elderly patients is debatable and we analysed pathological and oncological outcomes of elderly men with clinically localized prostate cancer treated with radical prostatectomy. MATERIAL & METHODS: Data from 1,268 patients undergoing radical prostatectomy between 2000 and 2009 at four Japanese centres was retrospectively reviewed. Patients were classified according to whether they were of age < 70 or ≥ 70 years at the time of radical prostatectomy. Patient characteristics, pathological and oncological outcomes were compared among the groups. RESULTS: Of the total population, 31.4% (398/1268) of patients were ≥ 70 years of age. Median age at radical prostatectomy was 64 (4569) years among patients younger than 70 years and was 72 (70-83) years in those ≥ 70 years of age. According to D’Amico risk classification, the proportion of low-risk disease was significantly lower among those ≥ 70 years of age than in those younger than 70 years, while the proportion of high-risk disease was significantly higher among those ≥ 70 years of age than in those younger than 70 years (P<0.001). The proportions of pathological high-risk disease (≥ T3b, GS ≥ 8, positive surgical margin or lymph node invasion) in patients < 70 and ≥ 70 years of age were 42.0% and 50.0%, respectively (P=0.008). The proportions of organ-confined disease in patients < 70 and ≥ 70 years of age were 65.1% and 69.9%, respectively (P=0.09). With a median follow-up of 50 months, five-year biochemical recurrencefree survival and cancer-specific survival were not significantly different among the groups. CONCLUSIONS: Radical prostatectomy was more likely to be performed in those with higher-risk disease among patients ≥ 70 years of age than in those younger than < 70 years. About half of patients with ≥ 70 years of age had pathological high-risk disease. Oncological outcomes were excellent, although longer follow-up is needed.
Pathological and oncological outcomes of elderly men with clinically localized prostate cancer Eur Urol Suppl 2014;13;e749
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Mitsuzuka K. 1 , Koie T.2 , Narita S. 3 , Kaiho Y. 1 , Yoneyama T.2 , Tsuchiya N.3 , Kawamura S. 4 , Tochigi T.4 , Ohyama C.2 , Habuchi T.3 , Arai Y. 1 , Michinoku Japan Urological Cancer Study Group, Sendai, Japan 1 Tohoku
University Of Medical School, Dept. of Urology, Sendai, Japan, 2 Hirosaki University of Medical School, Dept. of Urology, Hirosaki,
Japan, 3 Akita University of Medical School, Dept. of Urology, Akita, Japan, 4 Miyagi Cancer Center, Dept. of Urology, Natori, Japan INTRODUCTION & OBJECTIVES: Radical prostatectomy for elderly patients is debatable and we analysed pathological and oncological outcomes of elderly men with clinically localized prostate cancer treated with radical prostatectomy. MATERIAL & METHODS: Data from 1,268 patients undergoing radical prostatectomy between 2000 and 2009 at four Japanese centres was retrospectively reviewed. Patients were classified according to whether they were of age < 70 or ≥ 70 years at the time of radical prostatectomy. Patient characteristics, pathological and oncological outcomes were compared among the groups. RESULTS: Of the total population, 31.4% (398/1268) of patients were ≥ 70 years of age. Median age at radical prostatectomy was 64 (4569) years among patients younger than 70 years and was 72 (70-83) years in those ≥ 70 years of age. According to D’Amico risk classification, the proportion of low-risk disease was significantly lower among those ≥ 70 years of age than in those younger than 70 years, while the proportion of high-risk disease was significantly higher among those ≥ 70 years of age than in those younger than 70 years (P<0.001). The proportions of pathological high-risk disease (≥ T3b, GS ≥ 8, positive surgical margin or lymph node invasion) in patients < 70 and ≥ 70 years of age were 42.0% and 50.0%, respectively (P=0.008). The proportions of organ-confined disease in patients < 70 and ≥ 70 years of age were 65.1% and 69.9%, respectively (P=0.09). With a median follow-up of 50 months, five-year biochemical recurrencefree survival and cancer-specific survival were not significantly different among the groups. CONCLUSIONS: Radical prostatectomy was more likely to be performed in those with higher-risk disease among patients ≥ 70 years of age than in those younger than < 70 years. About half of patients with ≥ 70 years of age had pathological high-risk disease. Oncological outcomes were excellent, although longer follow-up is needed.