Survival in prostate cancer patients ≥70 years after radical prostatectomy and comparison to younger patients

Abstract

The purpose of our study was to evaluate and compare the survival in prostate cancer (PCa) patients who underwent radical prostatectomy (RP) < and > or = 70 years. In a prospective cancer database, 626 patients with PCa underwent RP. Patients were categorised into two groups as follows: <70 years (n = 526, young) and > or = 70 years (n = 100, old). We evaluated the histopathological features as well as the clinical follow-up after RP. The median age was 64.4 years (41.1-80.1 years). The median follow-up was 5.3 years (0.1-15.8 years). The preoperative median prostate-specific antigen (PSA) levels for young and old patients were 8.8 ng/ml (0.4-230.0 ng/ml) and 9.9 ng/ml (0.3-165.0 ng/ml). Serum PSA levels were not different comparing the two groups (P = 0.356). The young and old patients had an organ-confined PCa in 56.3 and 58.0% (P = 0.826). They had well and moderately differentiated tumours in 78.7 and 75.0% of cases and poorly differentiated tumours in 21.3 and 25.0% (P = 0.198). Young and old patients had an ECOG > 1 in 2.3% and 7.0% of cases (P = 0.024). A 10-year PSA-free survival for young and old patients was 51.8 and 57.4% (P = 0.721), 10-year-disease-specific survival was 92.3 and 97.6% (P = 0.342), 10-year metastasis-free survival was 86.9 and 89.7% (P = 0.713), and 10-year-overall-survival was 78.1 and 71.2% (P = 0.565). Besides classical risk factors for adverse outcome on multivariate analysis, such as preoperative PSA-levels, extracapsular extension, tumour grade, and positive margin status, age was not a predictor for PSA-free- (P = 0.407), disease-specific- (P = 0.257), and overall-survival (P = 0.121). In a well-selected healthy, elderly population survival outcome is not worse than that of younger patients with a follow-up of 5.3 years and curative treatment should be recommended.