title: Survival in prostate cancer patients > or = 70 years after radical prostatectomy and comparison to younger patients.
abstract: OBJECTIVE
  The purpose of our study was to evaluate and compare the survival in prostate cancer (PCa) patients who underwent radical prostatectomy (RP) < and > or = 70 years.
  
  
  METHODS
  In a prospective cancer database, 626 patients with PCa underwent RP. Patients were categorised into two groups as follows: <70 years (n = 526, young) and > or = 70 years (n = 100, old). We evaluated the histopathological features as well as the clinical follow-up after RP. The median age was 64.4 years (41.1-80.1 years). The median follow-up was 5.3 years (0.1-15.8 years). The preoperative median prostate-specific antigen (PSA) levels for young and old patients were 8.8 ng/ml (0.4-230.0 ng/ml) and 9.9 ng/ml (0.3-165.0 ng/ml).
  
  
  RESULTS
  Serum PSA levels were not different comparing the two groups (P = 0.356). The young and old patients had an organ-confined PCa in 56.3 and 58.0% (P = 0.826). They had well and moderately differentiated tumours in 78.7 and 75.0% of cases and poorly differentiated tumours in 21.3 and 25.0% (P = 0.198). Young and old patients had an ECOG > 1 in 2.3% and 7.0% of cases (P = 0.024). A 10-year PSA-free survival for young and old patients was 51.8 and 57.4% (P = 0.721), 10-year-disease-specific survival was 92.3 and 97.6% (P = 0.342), 10-year metastasis-free survival was 86.9 and 89.7% (P = 0.713), and 10-year-overall-survival was 78.1 and 71.2% (P = 0.565). Besides classical risk factors for adverse outcome on multivariate analysis, such as preoperative PSA-levels, extracapsular extension, tumour grade, and positive margin status, age was not a predictor for PSA-free- (P = 0.407), disease-specific- (P = 0.257), and overall-survival (P = 0.121).
  
  
  CONCLUSIONS
  In a well-selected healthy, elderly population survival outcome is not worse than that of younger patients with a follow-up of 5.3 years and curative treatment should be recommended.
authors.affiliation: Department of Urology, University of Heidelberg, INF 110, 69120 Heidelberg, Germany. Jesco.Pfitzenmaier@med.uni-heidelberg.de
authors.forename: Jesco
authors.initials: J
authors.lastname: Pfitzenmaier
authors.forename: Sascha
authors.initials: S
authors.lastname: Pahernik
authors.forename: Stephan
authors.initials: S
authors.lastname: Buse
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
authors.forename: Nenad
authors.initials: N
authors.lastname: Djakovic
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate