[Do older men with localized prostate cancer Gleason 8-10 benefit from curative therapy?].
OBJECTIVE
The aim is to analyse until which age a radical procedure could have an influence on life expectancy of patients with localized prostate cancer Gleason 8-10.


METHODS
We analyse retrospectively 80 patients with localized prostate cancer T1-2N0-XM0 Gleason 8-10. The patients were stratified in 2 groups: group A 34 patients who received hormonal treatment and group B, 46 patients submitted to radical prostatectomy. The analysed variables are: cancer mortality and cancer specific survival.


RESULTS
Patients characteristics: median age group A 75 years (66-84) and group B 64 years (56-75) (p = 0.033): median followup group A 54 months (20-180) and group B 37 months (12-140) (p = 0.016); median Gleason group A 8 (8-10) and group B 8 (8-10) (p = 0.144); percentage T1 group A 24% and group B 41% (p = 0.096); median PSA group A 10 (4-91) and group B 12 (4-71) (p = 0.269). The cancer specific mortality from group A is 24 (71%) and in group B 3 (7%) (p = 0.000). In the first 5 years, 20 (59%) patients died from prostate cancer in the group A and 1 (2%) in the group B. The Kaplan-Meier curves and Log-Rank test show significant differences in the survival cancer specific between the 2 groups. The Cox regression shows that the possibilities of dying from prostate cancer are higher in the group of patients who did not receive treatment with curative intention. The relative risk (HR 95% IC) in group A is 6.826 (2.032-22.931).


CONCLUSIONS
More than half of the patients with localized prostate cancer Gleason 8-10 treated in a conservative way die from cancer within the next 5 years since the diagnosis. The patients with a life expectancy greater than 5 years can benefit with a curative treatment.
Ojea Calvo
A
A
Complejo Hospitalario Universitario de Vigo, Pontevedra. antonio.ojea.calvo@sergas.es
López García
S
S
Rey Rey
J
J
Alonso Rodrigo
A
A
Rodríguez Iglesias
B
B
Barros Rodríguez
J M
JM
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate