Radical Prostatectomy in Korean Men Aged 75-Years or Older: Safety and Efficacy in Comparison with Patients Aged 65-69 Years

Prostate cancer is the most common type of male cancer worldwide. Although radical prostatectomy (RP) is advised for prostate cancer in patients with a life expectancy of more than 10 years by various guidelines, most elderly men still do not undergo the procedure regardless of increasing life expectancy. This study aimed to determine whether RP is suitable for patients with prostate cancer aged 75 years or older. A retrospective study of patients who underwent RP at 6 institutions between 2005 and 2012 was conducted. Patients were divided into 2 groups at the time of surgery: 65-69 years (younger group) and 75 years or older (older group). We compared clinical characteristics, pathological results, complication rates, and recurrence-free survival between the two groups. Compared with the younger group, the older group had significantly higher preoperative serum prostate-specific antigen level, pre- and postoperative Eastern Cooperative Oncology Group (ECOG) performance status grade, hypertension prevalence, and Gleason score at biopsy and RP. However, except urinary incontinence, there were no statistically significant differences in the peri- and post-operative complications. After median follow-up periods of 36 months (younger group) and 40 months (older group), the biochemical recurrence-free survival rates were not significantly different (P = 0.581). Although the urinary incontinence rate was higher in the older group, RP was a suitable option for selected Korean men aged 75 years or older with limited complication rates and excellent outcomes similar to those for patients aged 65-69 years.

Journal of Korean medical science. 2016 Apr 25 [Epub]

Jae Hyun Ryu, Yun Beom Kim, Tae Young Jung, Sun Il Kim, Seok-Soo Byun, Dong Deuk Kwon, Duk Yoon Kim, Tae Hee Oh, Tag Keun Yoo, Woo Jin Ko

Department of Urology, Veterans Health Service Medical Center, Seoul, Korea ., Department of Urology, Veterans Health Service Medical Center, Seoul, Korea ., Department of Urology, Veterans Health Service Medical Center, Seoul, Korea ., Department of Urology, Ajou University School of Medicine, Suwon, Korea ., Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea ., Department of Urology, Chonnam National University Medical School, Gwangju, Korea ., Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea ., Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea ., Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea ., Department of Urology, National Health Insurance Corporation Ilsan Hospital, Yonsei University College of Medicine, Goyang, Korea .