This study aimed to analyze the survival rate and to examine the risk of death from prostate cancer when accounting for competing risk of death, in men aged ≥80 years treated with primary androgen deprivation therapy (ADT). Data of patients with prostate cancer who had received ADT were extracted from a nationwide community-based database established by the Japan Study Group for Prostate Cancer. Prognostic variables, including progression-free survival, cancer-specific survival, overall survival, and death rates were compared between men stratified by prostate cancer risk. In all, 4760 patients elder than 80-year were included. The proportion of low-, intermediate-, high-, very high-risk, regional and metastatic prostate cancer among super-elderly men was 9.5%, 14.6%, 48.8%, 9.0%, 3.2%, and 24.9%, respectively. Survival rates decreased with increasing risk stratification. The cumulative 5-year death rate by prostate cancer for low-, intermediate-, high-, very high-risk, regional, and metastatic prostate cancer, was 0.92% (95% confidence interval [CI], 0.2-3.6%), 1.6% (95% CI, 0.8-3.4%), 5.75% (95% CI, 4.25-7.75%), 15.6% (95% CI, 11.6-23.3%), 20.7% (95% CI, 13.1-31.7%), and 36.9% (95% CI, 32.8-41.4%), respectively. Our findings support that there is no need for immediate ADT for low- and intermediate-risk groups. On the other hand, in high-, very high-risk, regional, and metastatic prostate cancer, more effort for curative therapy and intensive therapy are needed in selected patients.
Cancer science. 2021 May 20 [Epub ahead of print]
Leandro Blas, Mizuki Onozawa, Masaki Shiota, Shiro Hinotsu, Shinichi Sakamoto, Yasuhide Kitagawa, Taketo Kawai, Masatoshi Eto, Haruki Kume, Hideyuki Akaza, Japan Study Group of Prostate Cancer (J-CaP)
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Department of Urology, International University of Health and Welfare, Narita Hospital, Chiba, Japan., Department of Biostatistics and Clinical Epidemiology, Sapporo Medical University, Sapporo, Japan., Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan., Department of Urology, Komatsu Municipal Hospital, Komatsu, Japan., Department of Urology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan., Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan.