Ranasinghe Weranja, Wang Luke L, Persad Raj, Bolton Damien, Lawrentschuk Nathan, Sengupta Shomik
Urology Unit, Austin Health, Melbourne, Victoria, Australia.
Department of Urology, Eastern Health, Melbourne, Victoria, Australia.
ANZ J Surg. 2018 Mar;88(3):E189-E193. doi: 10.1111/ans.14166. Epub 2017 Sep 18.
To investigate the outcomes of patients older than 75 years of age in Victoria undergoing radical prostatectomy for prostate cancer.
Data on all men undergoing radical prostatectomy in Victoria between 1 January 2004 and 31 December 2014 were obtained from the Victorian Cancer Registry. Tumour characteristics including Gleason grade, stage of disease and cause of death were obtained. Statistical analysis was performed using chi-squared test, Cox proportional hazards method and Kaplan-Meier analysis.
A total of 14 686 men underwent radical prostatectomy during the defined period, with a median follow-up of 58 months. Of these, 332 were men over the age of 75. All parameters are comparisons between patients >75 years of age and men <75 years of age. Men >75 years had a higher proportion of Gleason grade ≥8 disease (16.6% versus 11.4%, P < 0.001) but had similar stage of disease. Men >75 years had lower rates of 5- and 10-year overall survival (67.3% versus 96.3% and 27.7% versus 89.1%) and lower rates of 5- and 10-year prostate cancer-specific survival (96.2% versus 99.3% and 94.3% versus 97.4%), respectively. Age was an independent risk factor for prostate cancer specific and overall mortality on multivariate analysis (hazard ratio 1.49, 95% confidence interval 1.32-1.68; P < 0.001 and hazard ratio 4.26, 95% confidence interval 2.15-8.42; P < 0.001), when adjusted for stage and grade.
Older men undergoing radical prostatectomy in Victoria had higher-grade disease but similar stage. Age was an independent risk factor for worse prostate cancer-specific and overall survival.
调查维多利亚州75岁以上男性接受前列腺癌根治术的治疗结果。
从维多利亚癌症登记处获取2004年1月1日至2014年12月31日期间在维多利亚州接受前列腺癌根治术的所有男性的数据。获取肿瘤特征，包括 Gleason 分级、疾病分期和死亡原因。使用卡方检验、Cox 比例风险法和 Kaplan-Meier 分析进行统计分析。
在规定期间，共有14686名男性接受了前列腺癌根治术，中位随访时间为58个月。其中，332名是75岁以上的男性。所有参数均为75岁以上患者与75岁以下男性之间的比较。75岁以上男性 Gleason 分级≥8级疾病的比例更高（16.6% 对 11.4%，P < 0.001），但疾病分期相似。75岁以上男性的5年和10年总生存率较低（分别为67.3% 对 96.3% 和27.7% 对 89.1%），5年和10年前列腺癌特异性生存率也较低（分别为96.2% 对 99.3% 和94.3% 对 97.4%）。多因素分析时，校正分期和分级后，年龄是前列腺癌特异性死亡和总死亡的独立危险因素（风险比1.49，95% 置信区间1.32 - 1.68；P < 0.001和风险比4.26，95% 置信区间2.15 - 8.42；P < 0.001）。
在维多利亚州接受前列腺癌根治术的老年男性疾病分级较高，但分期相似。年龄是前列腺癌特异性生存率和总生存率较差的独立危险因素。
