You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2014PD12-04 THE EFFECT OF AGE AT DIAGNOSIS ON PROSTATE CANCER MORTALITY: A GRADE-FOR-GRADE AND STAGE-FOR-STAGE ANALYSIS Giorgio Gandaglia, Firas Abdollah, Jonas Schiffmann, Florian Roghmann, Andreas Becker, Vincent Trudeau, Paul Perrotte, Alberto Briganti, Francesco Montorsi, Pierre I. Karakiewicz, Quoc-Dien Trinh, and Maxine Sun Giorgio GandagliaGiorgio Gandaglia More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Jonas SchiffmannJonas Schiffmann More articles by this author , Florian RoghmannFlorian Roghmann More articles by this author , Andreas BeckerAndreas Becker More articles by this author , Vincent TrudeauVincent Trudeau More articles by this author , Paul PerrottePaul Perrotte More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , and Maxine SunMaxine Sun More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.976AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The effect of age at diagnosis on cancer control in men with prostate cancer (PCa) has not been fully elucidated. To address this issue, we set out to assess the impact of age on long-term cancer-specific mortality (CSM) rates in a large cohort of patients with clinically localized PCa treated with radical prostatectomy (RP). Our hypothesis stated that, although other-cause mortality (OCM) represents the leading cause of death in older patients, the risk of dying from PCa is not negligible, particularly in those with aggressive tumor characteristics. METHODS Overall, 205,551 patients with clinically localized PCa diagnosed between 1988 and 2009 within the Surveillance Epidemiology and End Results (SEER) database were included. Patients were stratified according to age: ≤50, 51-60, 61-70, and ≥71 years. All patients were treated with RP. The 15-year cumulative incidence CSM rates were computed. Competing-risks regression models were performed to test the effect of age on CSM in the entire cohort, and for each grade (Gleason score 2-4, 5-7, and 8-10) and stage (pT2, pT3a, and pT3b) sub-cohorts. RESULTS The proportion of patients aged ≤50 years at diagnosis increased over the study period: from 2.6% between 1988–1994 to 8.5% between 2007–2009 (P≤0.001). Similarly, the median age at diagnosis decreased from 66 years in 1988 to 61 years in 2009 (Figure 1; P≤0.001). Overall, 14,871 (7.2%), 73,734 (35.9%), 97,637 (47.5%), and 19,579 (9.5%) patients were aged ≤50, 51-60, 61-70, ≥71 years, respectively. Advancing age was associated with higher 15-year CSM rates (2.3 vs. 3.4 vs. 4.6 vs. 6.3% for patients aged ≤50 vs. 51-60 vs. 61-70 vs. ≥71 years, respectively; P<0.001). In multivariable analyses, age at diagnosis was a significant predictor of CSM, after accounting for confounders. This relationship was also observed in sub-analyses focusing on patients with Gleason score 5-7, and/or pT2 disease (all P≤0.05). Conversely, the effect of age failed to reach independent predictor status in men with Gleason score 2-4, 8-10, pT3a, and/or pT3b disease. CONCLUSIONS Our findings show that older patients are at higher risk of CSM compared to their younger counterparts, after accounting for the risk of dying from other causes. When considering patients affected by more aggressive disease, age at diagnosis does not represent an independent predictor of CSM. Thus, in high-risk patients, tumor characteristics, rather than chronological age, should be considered when making treatment decisions. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e347-e348 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giorgio Gandaglia More articles by this author Firas Abdollah More articles by this author Jonas Schiffmann More articles by this author Florian Roghmann More articles by this author Andreas Becker More articles by this author Vincent Trudeau More articles by this author Paul Perrotte More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Pierre I. Karakiewicz More articles by this author Quoc-Dien Trinh More articles by this author Maxine Sun More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...