Survival of men with clinically localized prostate cancer detected in the eighth decade of life.

We reviewed our experience with the management of men 70 to 79 years old with clinically localized prostate cancer to determine whether surgical candidates were likely to die of intercurrent disease soon after the disease was diagnosed. Of 101 men in the eighth decade of life who were surgical candidates by all criteria other than patient age 44 underwent radical prostatectomy, whereas 57 were managed by medical therapy including observation, radiation therapy and/or androgen deprivation. Five patients died in the surgical group at a median followup of 59 months, only 1 of whom died of intercurrent disease. Among 15 deaths in the medical group metastatic prostate cancer was the most common cause and all deaths from prostate cancer occurred more than 3 years after diagnosis. Survival for the surgical group was significantly better than that for the medical group during followup (p < 0.01 log-rank test). We conclude that men at our institution who underwent radical prostatectomy in the eighth decade of life did not frequently die of intercurrent disease, and experienced acceptable morbidity and mortality rates. We believe that men with localized prostate cancer should not be denied a radical operation based on age alone.