Sina Vatandoust1,2,3, Ganessan Kichenadasse1,2,3, Michael O'Callaghan1,2,4,5,6, Andrew D Vincent5,6, Tina Kopsaftis2,4, Scott Walsh2,4, Martin Borg2,6,7, Christos S Karapetis1,3, Kim Moretti1,2,5,6,8. 1. Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia. 2. The South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, SA, Australia. 3. Department of Medical Oncology, Flinders Medical Centre, Bedford Park, SA, Australia. 4. Urology Unit, Repatriation General Hospital, Daw Park, Adelaide, SA, Australia. 5. Freemasons Foundation Centre for Men's Health, Adelaide, SA, Australia. 6. University of Adelaide, Adelaide, SA, Australia. 7. Adelaide Radiotherapy Centre, Adelaide, SA, Australia. 8. University of South Australia, Adelaide, SA, Australia.
Abstract
OBJECTIVES: To investigate the rate of prostate cancer-specific mortality (PCSM) and disease characteristics in patients diagnosed with localised prostate cancer at age 80-89 years in comparison with men diagnosed at age 70-79 years. PATIENTS AND METHODS: 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 years 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 vs non-curative) and treatment effect on PCSM. RESULTS: Of the 1 951 eligible patients, 1 428 (76%) were aged 70-79 years and 460 (24%) were aged 80-89 years at diagnosis, with a median (interquartile range) age of 74 (72-76) and 83 (81-85) years, respectively. The 80-89 years group had higher Gleason scores and Prostate Specific Antigen (PSA) values (all P < 0.001) in comparison with the younger group. The 80-89 years group were less likely to be treated with curative treatment (odds ratio 0.12, 95% confidence interval 0.09-0.16; P < 0.001). The proportion of deaths attributable to prostate cancer was similar in both groups: 73 of 263 deaths (28%) in the 80-89 years group vs 97 of 310 deaths (31%) in the 70-79 years group. The risk of PCSM in individuals treated with curative intent was reduced in both groups. CONCLUSIONS: The proportion of prostate cancer deaths was similar in both groups. These findings support carefully selected individualised management of elderly patients diagnosed with localised prostate cancer.
OBJECTIVES: To investigate the rate of prostate cancer-specific mortality (PCSM) and disease characteristics in patients diagnosed with localised prostate cancer at age 80-89 years in comparison with men diagnosed at age 70-79 years. PATIENTS AND METHODS: 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 years 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 vs non-curative) and treatment effect on PCSM. RESULTS: Of the 1 951 eligible patients, 1 428 (76%) were aged 70-79 years and 460 (24%) were aged 80-89 years at diagnosis, with a median (interquartile range) age of 74 (72-76) and 83 (81-85) years, respectively. The 80-89 years group had higher Gleason scores and Prostate Specific Antigen (PSA) values (all P < 0.001) in comparison with the younger group. The 80-89 years group were less likely to be treated with curative treatment (odds ratio 0.12, 95% confidence interval 0.09-0.16; P < 0.001). The proportion of deaths attributable to prostate cancer was similar in both groups: 73 of 263 deaths (28%) in the 80-89 years group vs 97 of 310 deaths (31%) in the 70-79 years group. The risk of PCSM in individuals treated with curative intent was reduced in both groups. CONCLUSIONS: The proportion of prostate cancer deaths was similar in both groups. These findings support carefully selected individualised management of elderly patients diagnosed with localised prostate cancer.
Authors: Kim Moretti; Sina Vatandoust; Ganessan Kichenadasse; Michael E O'Callaghan; Andrew D Vincent; Tina Kopsaftis; Scott Walsh; Martin Borg; Chris Karapetis Journal: World J Urol Date: 2018-05-10 Impact factor: 4.226
Authors: Kun Jin; Shi Qiu; Jiakun Li; Xiaonan Zheng; Xiang Tu; Xinyang Liao; Yan Yang; Lu Yang; Qiang Wei Journal: Cancer Med Date: 2019-05-08 Impact factor: 4.452