Department of Urology, University of Rochester Medical Center, Rochester, New York 14642, USA.
Cancer. 2012 Jun 15;118(12):3062-70. doi: 10.1002/cncr.26392. Epub 2011 Oct 17.
The objectives of this study were to determine the frequency of metastatic (M1) prostate cancer (PC) at presentation in different age groups, to examine the association of age with PC-specific mortality, and to calculate the relative contribution of different age groups to the pool of M1 cases and PC deaths.
Records from 464,918 patients who were diagnosed with PC from 1998 to 2007 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were categorized according to age into groups ages <50 years, 50 to 54 years, 55 to 59 years, 60 to 64 years, 65 to 69 years, 70 to 74 years, 75 to 79 years, 80 to 84 years, 85 to 89 years, and ≥ 90 years. The cumulative incidence of death from PC was computed using the Gray method.
The frequency of M1 PC at presentation was 3% for the group aged <75 years, 5% for the group ages 75 to 79 years, 8% for the group ages 80 to 84 years, 13% for the group ages 85 to 89 years, and 17% for the group aged ≥ 90 years. The 5-year cumulative incidence of death from PC was 3% to 4% for all patients with PC in any category aged <75 years, 7% for patients ages 75 to 79 years, 13% for patients ages 80 to 84 years, 20% for patients ages 85 to 89 years, and 30% for patients aged ≥ 90 years. Although patients aged ≥ 75 years at PC diagnosis represented just over a quarter (26%) of all PC cases, they contributed almost half (48%) of all M1 cases and more than half (53%) of all PC deaths.
Compared with younger patients (aged <75 years), older patients were more likely to present with very advanced disease, had a greater risk of death from PC despite higher death rates from competing causes, and contributed more than half of all PC deaths. Awareness of this issue may improve future outcomes for elderly patients with PC.
本研究的目的是确定不同年龄组中转移性（M1）前列腺癌（PC）的发病频率，研究年龄与 PC 特异性死亡率的关系，并计算不同年龄组对 M1 病例和 PC 死亡人数的相对贡献。
从 1998 年至 2007 年从监测、流行病学和最终结果（SEER）数据库中获得了 464918 名被诊断为 PC 的患者的记录。患者根据年龄分为 <50 岁、50-54 岁、55-59 岁、60-64 岁、65-69 岁、70-74 岁、75-79 岁、80-84 岁、85-89 岁和≥90 岁。使用 Gray 方法计算 PC 死亡的累积发生率。
在 <75 岁的年龄组中，M1 PC 的发病频率为 3%，在 75-79 岁的年龄组中为 5%，在 80-84 岁的年龄组中为 8%，在 85-89 岁的年龄组中为 13%，在≥90 岁的年龄组中为 17%。所有 <75 岁的 PC 患者的 5 年 PC 死亡累积发生率为 3%-4%，75-79 岁患者为 7%，80-84 岁患者为 13%，85-89 岁患者为 20%，≥90 岁患者为 30%。尽管诊断为 PC 时年龄≥75 岁的患者仅占所有 PC 病例的四分之一以上（26%），但他们几乎贡献了所有 M1 病例的一半（48%）和所有 PC 死亡人数的一半以上（53%）。
与年轻患者（<75 岁）相比，年龄较大的患者更有可能出现非常晚期的疾病，尽管由于竞争原因导致死亡率较高，但死于 PC 的风险更高，并且贡献了所有 PC 死亡人数的一半以上。了解这一问题可能会改善老年 PC 患者的未来预后。
