Department of Urology, Tohoku University Graduate School of Medicine, Sendai Michinoku Japan Urological Cancer Study Group
Michinoku Japan Urological Cancer Study Group Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki.
Jpn J Clin Oncol. 2014 Jun;44(6):587-92. doi: 10.1093/jjco/hyu038. Epub 2014 Apr 9.
To compare oncological outcomes of patients aged ≥70 years treated with radical prostatectomy with those of a clinically matched younger cohort.
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.
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).
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.
比较≥70 岁接受根治性前列腺切除术患者与临床匹配的年轻患者的肿瘤学结局。
回顾性分析 2000 年至 2009 年间接受根治性前列腺切除术的 1268 例患者的数据。根据前列腺切除术时的年龄（<70 岁或≥70 岁）将患者分类。在匹配术前因素（即前列腺特异性抗原、阳性活检核心、Gleason 评分、临床分期和 D'Amico 风险组）后，从每个组中选择 333 例患者。
年龄<70 岁和≥70 岁患者中病理分期≥T3 的比例分别为 30.3%和 33.0%（P=0.51）。两组患者病理 Gleason 评分≤6、7 和≥8 的比例无显著差异（P=0.08）。年龄<70 岁和≥70 岁患者中器官局限性疾病的比例分别为 69.4%和 67.0%（P=0.56）。中位随访 50 个月后，年龄<70 岁和≥70 岁患者的 5 年前列腺特异性抗原无复发生存率分别为 83.4%和 80.1%（对数秩检验，P=0.199）。年龄<70 岁和≥70 岁患者的 5 年癌症特异性生存率分别为 100%和 99.4%（对数秩检验，P=0.317）。年龄<70 岁和≥70 岁患者的 5 年总生存率分别为 98.4%和 96.4%（对数秩检验，P=0.228）。
接受根治性前列腺切除术的老年（≥70 岁）患者的病理和肿瘤学结局与年轻患者（<70 岁）无显著差异。这些信息将有助于为老年男性局限性前列腺癌的确定性治疗提供更明确的适应证。
