Long-term results of definitive treatment in elderly patients with localized prostate cancer.
BACKGROUND
The indication and effectiveness of definitive local treatment for prostate cancer in patients with a limited life expectancy remains to be established. This study is a retrospective analysis of the long-term clinical outcome of elderly patients with localized prostate cancer treated by radiotherapy or a radical prostatectomy.


METHODS
From 1982 to 1992, 37 patients with localized prostate cancer, aged 70 years or older, were treated initially by a pelvic lymphadenectomy and then with either external radiotherapy (n = 1 7) or a radical retropubic prostatectomy (n = 20). Lymph node metastasis was negative in all the cases, and no patients received hormonal treatment after the lymphadenectomy. The outcome of all patients was evaluated in June 1997.


RESULTS
The 10-year overall and relative survival rates for the radiotherapy group were 27% and 85%, which were not significantly different from the rates of patients in the prostatectomy group (38% and 74%, respectively). The 5-year progression free rates for the radiotherapy group and the prostatectomy group were 63% and 95%, respectively (P= 0.06).


CONCLUSIONS
In elderly patients with localized prostate cancer, the superiority of a radical prostatectomy over radiotherapy was not demonstrated in terms of either overall or relative survival rates, although the progression rate tended to be higher in patients in the radiotherapy group. The indication of definitive treatment in elderly patients should be further studied incorporating a quality of life assessment.
Kanamaru
H
H
Department of Urology, Fukui Medical University, Matsuoka, Japan.
Arai
Y
Y
Moroi
S
S
Yoshida
H
H
Yoshimura
K
K
Okada
K
K
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome