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World Journal of Urology

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27.06.2018 | Original Article

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

verfasst von: Wei Sheng, Ruth Kirschner-Hermanns, Hongwei Zhang

Erschienen in: World Journal of Urology | Ausgabe 2/2019

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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.

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Titel: Elderly patients aged ≥ 75 years with locally advanced prostate cancer may benefit from local treatment: a population-based propensity score-adjusted analysis
verfasst von: Wei Sheng
Ruth Kirschner-Hermanns
Hongwei Zhang
Publikationsdatum: 27.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 2/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2389-1

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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

Methods

Results

Conclusion

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Abstract

Objective

Methods

Results

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