Radical prostatectomy for clinically localized prostate cancer in patients aged 75 years or older: comparison with primary androgen deprivation therapy. (2nd January 2018)

• Record Type: Journal Article
• Authors: Ryu, Jae Hyun; Kim, Sang Jin; Kim, Yun Beom; Jung, Tae Young; Ko, Woo Jin; Kim, Sun Il; Kim, Duk Yoon; Oh, Tae Hee; Moon, Kyong Tae; Cho, Hee Ju; Cho, Jeong Man; Yoo, Tag Keun
• Is Part Of: Aging male. Volume 21:Number 1(2018)
• Page Start: 17
• Page End: 23
• Publication Date: 2018-01-02
• Subjects: Localized prostate cancer -- 75 years or old -- life expectancy -- radical prostatectomy -- primary androgen deprivation therapy; Aging -- Periodicals; Men -- Periodicals; Gerontology -- Periodicals; Men -- Health and hygiene -- Periodicals; Aging -- periodicals; Geriatric -- periodicals; Men -- periodicals; Aged -- periodicals; Aged, 80 and over -- periodicals; 612.67
• DOI: 10.1080/13685538.2017.1365122
• Languages: English
• ISSNs: 1368-5538

Abstract

Abstract: Objective: To determine whether radical prostatetomy (RP) is suitable for prostate cancer patients with age ≥75 years in comparison to primary androgen deprivation therapy (PADT). Patients and methods: A cohort study was conducted in clinically localized prostate cancer patients with ≥75 years of age who underwent RP or PADT at six institutions from 2005 to 2013. Patients who had less than 12 months of follow-up, or received neoadjuvant or adjuvant therapy were excluded. We compared clinical characteristics, cancer-specific and overall survivals, and post-treatment complication rates between two groups. Results: We included 92 and 99 patients in the RP and PADT groups, respectively. In survival analyses, there were no significant differences in cancer-specific and overall survivals ( p = .302 and .995, respectively). The incidence of serious adverse events (cardio- or cerebrovascular event, or bone fracture) was higher in the PADT group ( p = .001). Multivariable analysis showed that PADT had a worse effect on the serious adverse events (OR 10.12, p = .038). Conclusions: In selected elderly patients, RP was safe and effective for treatment of localized prostate cancer, as compared to PADT. Surgical treatment options should be considered in elderly patients with respect to life expectancy, rather than chronological age.