Abstract
Objective
To evaluate the effect of advancing age on cancer-specific mortality (CSM) after radical
prostatectomy (RP).
Materials and methods
Overall, 205,551 patients with PCa diagnosed between 1988 and 2009 within the Surveillance
Epidemiology and End Results (SEER) database were included in the study. Patients
were stratified according to age at diagnosis: ≤50, 51–60, 61–70, and ≥71 years. The
15-year cumulative incidence CSM rates were computed. Competing-risks regression models
were performed to test the effect of age on CSM in the entire cohort, and for each
grade (Gleason score 2–4, 5–7, and 8–10) and stage (pT2, pT3a, and pT3b) sub-cohorts.
Results
Advancing age was associated with higher 15-year CSM rates (2.3 vs. 3.4 vs. 4.6 vs.
6.3% for patients aged ≤50 vs. 51–60 vs. 61–70 vs. ≥71 years, respectively; P < 0.001). In multivariable analyses, age at diagnosis was a significant predictor
of CSM. This relationship was also observed in sub-analyses focusing on patients with
Gleason score 5–7, and/or pT2 disease (all P ≤ 0.05). Conversely, age failed to reach the independent predictor status in men
with Gleason score 2–4, 8–10, pT3a, and/or pT3b disease.
Conclusions
Advancing age increases the risk of CSM. However, when considering patients affected
by more aggressive disease, age was not significantly associated with higher risk
of dying from PCa. In high-risk patients, tumor characteristics rather than age should
be considered when making treatment decisions.
Keywords
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Article info
Publication history
Published online: May 21, 2014
Accepted:
May 4,
2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
