Ryu Jae Hyun, Kim Sang Jin, Kim Yun Beom, Jung Tae Young, Ko Woo Jin, Kim Sun Il, Kim Duk Yoon, Oh Tae Hee, Moon Kyong Tae, Cho Hee Ju, Cho Jeong Man, Yoo Tag Keun
a Department of Urology , Veterans Health Service Medical Center , Seoul , Republic of Korea.
b Department of Urology, National Health Insurance Corporation Ilsan Hospital , Goyang , Republic of Korea.
Aging Male. 2018 Mar;21(1):17-23. doi: 10.1080/13685538.2017.1365122. Epub 2017 Aug 22.
To determine whether radical prostatetomy (RP) is suitable for prostate cancer patients with age ≥75 years in comparison to primary androgen deprivation therapy (PADT).
A cohort study was conducted in clinically localized prostate cancer patients with ≥75 years of age who underwent RP or PADT at six institutions from 2005 to 2013. Patients who had less than 12 months of follow-up, or received neoadjuvant or adjuvant therapy were excluded. We compared clinical characteristics, cancer-specific and overall survivals, and post-treatment complication rates between two groups.
We included 92 and 99 patients in the RP and PADT groups, respectively. In survival analyses, there were no significant differences in cancer-specific and overall survivals (p = .302 and .995, respectively). The incidence of serious adverse events (cardio- or cerebrovascular event, or bone fracture) was higher in the PADT group (p = .001). Multivariable analysis showed that PADT had a worse effect on the serious adverse events (OR 10.12, p = .038).
In selected elderly patients, RP was safe and effective for treatment of localized prostate cancer, as compared to PADT. Surgical treatment options should be considered in elderly patients with respect to life expectancy, rather than chronological age.
与原发性雄激素剥夺疗法（PADT）相比，确定根治性前列腺切除术（RP）是否适用于年龄≥75岁的前列腺癌患者。
对2005年至2013年在六家机构接受RP或PADT治疗的年龄≥75岁的临床局限性前列腺癌患者进行队列研究。排除随访时间少于12个月或接受新辅助或辅助治疗的患者。我们比较了两组患者的临床特征、癌症特异性生存率和总生存率以及治疗后并发症发生率。
RP组和PADT组分别纳入92例和99例患者。在生存分析中，癌症特异性生存率和总生存率无显著差异（分别为p = 0.302和0.995）。PADT组严重不良事件（心血管或脑血管事件或骨折）的发生率更高（p = 0.001）。多变量分析显示，PADT对严重不良事件的影响更差（OR 10.12，p = 0.038）。
在选定的老年患者中，与PADT相比，RP治疗局限性前列腺癌安全有效。对于老年患者，应根据预期寿命而非实际年龄考虑手术治疗方案。
