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Elderly patients aged ≥ 75 years with locally advanced prostate cancer may benefit from local treatment: a population-based propensity score-adjusted analysis.

Abstract：

OBJECTIVE:To evaluate whether elderly patients aged ≥ 75 years with locally advanced prostate cancer (LAPC) may benefit from local treatment (LT). METHODS:Elderly patients aged ≥ 75 years with non-metastatic cT3-4 LAPC who were treated with LT [radical prostatectomy (RP), radiation therapy (RT)] or non-LT (NLT) were identified. After propensity score matching (PSM), cancer-specific mortality (CSM) and other-cause mortality (OCM) rates were assessed. In the assessment of LT vs. NLT and RP vs. RT, multivariable competing risk regression (MVA CRR) analysis was used. RESULTS:368 and 482 paired patients were matched for LT vs. NLT and RP vs. RT, respectively. 5 and 10 years CSM rates were 9.4 vs. 18.5% in LT and 24.9 vs. 29.3% in NLT-treated patients, respectively (P < 0.0001). 5 and 10 years CSM rates were 3.4% vs. 8.6% in RP and 6.7% vs. 15.1% in RT-treated patients, respectively (P = 0.10). In the MVA CRR model, after PSM, NLT resulted in higher CSM rates in Gleason score 8-10 [subhazard ratio (sHR) = 2.83, P < 0.001], cT3b/4 (sHR = 3.97/2.56, P = 0.003/0.002), cN0 (sHR = 2.52, P < 0.001) or PSA > 10 ng/ml [sHR (PSA = 10.1-20 ng/ml) = 4.59, P = 0.03; sHR (PSA > 20 ng/ml) = 2.77, P = 0.001] patients compared with LT. However, no statistically significant difference in CSM was observed between RP and RT, except for cT3a patients in whom higher CSM rates were noted for RT compared with RP (sHR = 3.91, P = 0.02). CONCLUSION:LAPC patients may benefit from local treatment despite advanced age. However, this benefit was only seen in patients with cT3b/4, Gleason score 8-10, cN0 or PSA > 10 ng/ml.

journal_name

World J Urol

journal_title

World journal of urology

authors

Sheng W,Kirschner-Hermanns R,Zhang H

doi

10.1007/s00345-018-2389-1

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

317-325

issue

2

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-018-2389-1

journal_volume

37

pub_type

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