Radical prostatectomy for clinically localized prostate cancer in patients aged 75 years or older: comparison with primary androgen deprivation therapy

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.

The aging male : the official journal of the International Society for the Study of the Aging Male. 2017 Aug 22 [Epub ahead of print]

Jae Hyun Ryu, Sang Jin Kim, Yun Beom Kim, Tae Young Jung, Woo Jin Ko, Sun Il Kim, Duk Yoon Kim, Tae Hee Oh, Kyong Tae Moon, Hee Ju Cho, Jeong Man Cho, Tag Keun Yoo

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., c Department of Urology, Ajou University School of Medicine , Suwon , Republic of Korea., d Department of Urology, Catholic University of Daegu School of Medicine , Daegu , Republic of Korea., e Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine , Changwon , Republic of Korea., f Department of Urology, Eulji General Hospital, Eulji University School of Medicine , Seoul , Republic of Korea.

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