Are pathological and oncological outcomes of elderly men treated with radical prostatectomy worse than those of younger men? Matched-pair analysis between patients aged <70 and ≥70 years.
OBJECTIVE
To compare oncological outcomes of patients aged ≥70 years treated with radical prostatectomy with those of a clinically matched younger cohort.


METHODS
Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to age (<70 or ≥70 years) at the time of prostatectomy. After matching pre-operative factors (i.e. prostate specific antigen, positive biopsy cores, Gleason score, clinical stage and D'Amico risk group), 333 patients were chosen from each group.


RESULTS
The percentage of pathological stage ≥T3 in those of age <70 and ≥70 years was 30.3 and 33.0%, respectively (P = 0.51). The percentage of pathological Gleason score ≤6, 7 and ≥8 was not significantly different between the two age groups (P = 0.08). The percentage of organ-confined disease in those of age <70 and ≥70 years was 69.4 and 67.0%, respectively (P = 0.56). With a median follow-up of 50 months, 5-year prostate specific antigen recurrence-free survival in those of age <70 and ≥70 years was 83.4 and 80.1%, respectively (log rank, P = 0.199). Five-year cancer-specific survival in those of age <70 and ≥70 years was 100 and 99.4%, respectively (log rank, P = 0.317). Five-year overall survival in those of age <70 and ≥70 years was 98.4 and 96.4%, respectively (log rank, P = 0.228).


CONCLUSIONS
Pathological and oncological outcomes in elderly patients (age ≥70 years) treated with radical prostatectomy were not significantly different from those of younger patients (age <70 years). This information will help refine the indications for definitive treatment for localized prostate cancer in elderly men.
Department of Urology, Tohoku University Graduate School of Medicine, Sendai Michinoku Japan Urological Cancer Study Group mitsuzuka@uro.med.tohoku.ac.jp.
Koji
K
Mitsuzuka
Michinoku Japan Urological Cancer Study Group Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki.
Takuya
T
Koie
Michinoku Japan Urological Cancer Study Group Department of Urology, Akita University Graduate School of Medicine, Akita.
Shintaro
S
Narita
Department of Urology, Tohoku University Graduate School of Medicine, Sendai Michinoku Japan Urological Cancer Study Group.
Yasuhiro
Y
Kaiho
Michinoku Japan Urological Cancer Study Group Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki.
Takahiro
T
Yoneyama
Michinoku Japan Urological Cancer Study Group Department of Urology, Akita University Graduate School of Medicine, Akita.
Norihiko
N
Tsuchiya
Michinoku Japan Urological Cancer Study Group Department of Urology, Miyagi Cancer Center, Natori, Japan.
Narihiko
N
Kakoi
Michinoku Japan Urological Cancer Study Group Department of Urology, Miyagi Cancer Center, Natori, Japan.
Sadafumi
S
Kawamura
Michinoku Japan Urological Cancer Study Group Department of Urology, Miyagi Cancer Center, Natori, Japan.
Tatsuo
T
Tochigi
Michinoku Japan Urological Cancer Study Group Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki.
Chikara
C
Ohyama
Michinoku Japan Urological Cancer Study Group Department of Urology, Akita University Graduate School of Medicine, Akita.
Tomonori
T
Habuchi
Department of Urology, Tohoku University Graduate School of Medicine, Sendai Michinoku Japan Urological Cancer Study Group.
Yoichi
Y
Arai
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D018572:Disease-Free Survival; D006801:Humans; D007564:Japan; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D060787:Neoplasm Grading; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
elderly; indication; matched-pair analysis; oncological outcome; radical prostatectomy