Pathological and oncological outcomes of elderly men with clinically localized prostate cancer.
OBJECTIVE
The aim of the study was to characterize pathological and oncological outcomes of elderly men with clinically localized prostate cancer treated with radical prostatectomy.


METHODS
Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to whether they were of age <70 or ≥70 years at radical prostatectomy. Patient characteristics, pathological and oncological outcomes were compared among the groups.


RESULTS
Of the total population, 31.4% (398 of 1268) of patients were ≥70 years of age. The median age in patients <70 and ≥70 years of age was 64 (45-69) and 72 (70-83) years. The proportion of low-risk disease was significantly lower among those ≥70 years of age than in those <70 years, while the proportion of high-risk disease was significantly higher among those ≥70 years of age than in those <70 years (P < 0.001). The proportions of pathological high-risk disease (≥T3b, GS ≥8, positive surgical margin or lymph node invasion) in patients <70 and ≥70 years of age were 42.0 and 50.0%, respectively (P = 0.008). The proportions of organ-confined disease in patients <70 and ≥70 years of age were 69.9 and 65.1%, respectively (P = 0.09). With a median follow-up of 50 months, 5-year biochemical recurrence-free and cancer-specific survival rates were not significantly different among the groups.


CONCLUSIONS
Radical prostatectomy was more likely to be performed in those with higher-risk disease among patients ≥70 years of age. About half of the patients ≥70 years of age had pathological, high-risk disease. Radical prostatectomy could be considered for patients with expected long-term life expectancy, even in the setting of advanced age.
*Department of Urology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan mitsuzuka@uro.med.tohoku.ac.jp.
Koji
K
Mitsuzuka
Takuya
T
Koie
Shintaro
S
Narita
Yasuhiro
Y
Kaiho
Takahiro
T
Yoneyama
Norihiko
N
Tsuchiya
Narihiko
N
Kakoi
Sadafumi
S
Kawamura
Tatsuo
T
Tochigi
Chikara
C
Ohyama
Tomonori
T
Habuchi
Yoichi
Y
Arai
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D012107:Research Design; D012371:Robotics; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
age; elderly; oncological outcome; radical prostatectomy