title: Impact of age at diagnosis on overall and disease-free survival in men with prostate cancer following conformal 3D radiation therapy.
abstract: OBJECTIVE
  The impact of age on prostate cancer outcome has been controversial. The aim of the study was to evaluate the role of age on overall survival and disease-free survival in patients affected by prostate cancer when treated with 3D conformal radiation therapy.
  
  
  METHODS
  From 1999 to 2005, 1002 patients with T1-T3 prostate cancer were treated with 3D conformal radiation therapy, delivering a median dose of 75.6, 66.6 and 45 Gy to the prostate, seminal vesicles and pelvic nodes (if necessary), respectively. Patients were divided into four groups (<65, 65-70, 70-75, >75 years) according to age at diagnosis. The relationship between age and both overall survival and disease-free survival was calculated with Kaplan-Meier analysis and the comparison between curves was performed by the logrank test. ROC analysis allowed assessment of the best age cutoff.
  
  
  RESULTS
  Mean age was 71 ± 6 years (median, 72). Median and mean follow-up was 71.4 and 69 months, respectively. In multivariate analysis, there was no significant difference in the distribution of disease risk between age groups. Analysis demonstrated that older age is a strong positive predictor of survival (odds ratio for stratified patients older than 70 years was <1). In fact, at the 90 month follow-up, overall survival and disease-free survival varied with age, increasing from 85% to 95% and from 78% to 94%, respectively. ROC curve analysis yielded a cutoff age value discriminating overall survival and disease-free survival of 72 years.
  
  
  CONCLUSIONS
  Age is a strong positive predictor of overall survival and disease-free survival, playing a protective role for stratified patients up to 72 years of age.
authors: Medical Physics IRCC Candiolo, Stradaprovinciale 142, Turin, Italy. angelo.maggio@ircc.it
authors: Angelo
authors: A
authors: Maggio
authors: Rocco
authors: R
authors: Panaia
authors: Elisabetta
authors: E
authors: Garibaldi
authors: Sara
authors: S
authors: Bresciani
authors: Giuseppe
authors: G
authors: Malinverni
authors: Michele
authors: M
authors: Stasi
authors: Pietro
authors: P
authors: Gabriele
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D019540:Area Under Curve; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D012372:ROC Curve; D020266:Radiotherapy, Conformal / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen