Localized prostate cancer in elderly men aged 80-89, findings from a population-based registry.
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Date
2018
Authors
Vatandoust, S.
Kichenadasse, G.
O'Callaghan, M.
Vincent, A.
Kopsaftis, T.
Walsh, S.
Borg, M.
Karapetis, C.
Moretti, K.
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BJU International, 2018; 121(S3):48-54
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Abstract
To investigate the rate of death due to Prostate Cancer (PCa) and disease characteristics in patients diagnosed with Localized Prostate Cancer (LPCa) at age 80-89 years in comparison with men diagnosed at age 70-79.This is a retrospective study of data from the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC). Included were men diagnosed between 2005 and 2014, aged ≥70 with no evidence of metastatic disease at presentation. Propensity score matching and competing risk Fine and Grey regression were used to assess the chance of treatment (curative v non-curative) and treatment effect on PCa specific-mortality.Of the 1951 eligible patients, 1428 (76%) aged 70-79, and 460 (24%) aged 80-89 yr at diagnosis (median age of 74 (IQR=72-76) and 83 (IQR=81-85) respectively). The 80-89 group had higher Gleason scores and PSA values (all p<0.001) in comparison with the younger group. The 80-89 group were less likely to be treated with curative treatment (OR=0.12, 95CI=[0.09, 0.16], p < 0.001). Proportion of deaths attributable to PCa was similar in both groups: 73 of 263 deaths (28%) in the 80-89 group vs 97 of 310 deaths (31%) in the 70-79 group. The risk of PCa mortality in individuals treated with curative intent was reduced in both groups.The proportion of PCa deaths was similar in both groups. These findings support carefully selected individualized management of elderly patients diagnosed with localized PCa. This article is protected by copyright. All rights reserved.
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Copyright 2018 The Authors BJU International. BJU International Published by John Wiley & Sons
Access Condition Notes: Accepted manuscript available after 1 April 2019