Age as a prognostic factor for disease recurrence after radical prostatectomy

Öbek, Can; Lai, Shenghan; Sadek, Samih; Civantos, Francisco; Soloway, Mark S.

doi:10.1016/s0090-4295(99)00168-5

Cited by 35 publications

(21 citation statements)

References 27 publications

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“…They reported biochemical recurrence in 12% of patients younger than 70 years old and in 25% of patients older than 70 years old. They concluded that age may be an independent prognostic factor for disease recurrence after RP [19]. However, in our study of patients with cT3a prostate cancer, we found a significant difference in OS between patients younger than 65 and patients 65 years or older (P = 0.015).…”

Section: The Influence Of Age On Survival Outcomescontrasting

confidence: 68%

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Correlations between age, Charlson score and outcome in clinical unilateral T3a prostate cancer

Hsu¹,

Joniau²,

Oyen³

et al. 2008

Asian J Androl

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According to the European Association of Urology (EAU) guidelines, a life expectancy of > 10 years is considered an important factor in the treatment of prostate cancer. The Charlson score is used to predict mortality based on comorbidities. The purpose of this study was to investigate the relationship between age, Charlson score and outcome in patients with cT3a prostate cancer. Between 1987 and 2004, 200 patients, who were with clinical T3a prostate cancer and who underwent radical prostatectomy (RP), were previously detected by digital rectal examination (DRE). Patients were categorized into two age groups (< 65 and ≥ 65 years old). Patients were also divided into two groups according to Charlson score ( = 0 and ≥ 1). Both age and Charlson score were analyzed regarding their predictive power of patients' outcomes. The mean follow-up period was 70.6 months, and the mean age of patients was 63.3 years. In all, 106 patients were < 65 years old and 94 patients were ≥ 65 years old. Age was a significant predictor of overall survival (OS). A Charlson score of 0 was found in 110 patients, and of ≥ 1 in 90 patients. Charlson score was not a significant predictor of biochemical progression-free survival (BPFS), clinical progression-free survival (CPFS) or OS. Cox multivariate analysis showed that margin status was a significant independent factor in BPFS, and cancer volume was a significant independent factor in CPFS. Charlson score does not influence the outcome in patients with clinical locally advanced prostate cancer. Age may influence OS. RP can be performed in motivated healthy older patients. However, the patients need to be counseled regarding possible surgery-related side effects, such as urinary incontinence and erectile dysfunction, which are age-and comorbidity-dependent.

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Section: The Influence Of Age On Survival Outcomescontrasting

confidence: 68%

“…They concluded that patients younger than 50 years old have a more favorable disease-free outcome [18]. Obek et al [19] studied 489 patients with localized prostate cancer. They reported biochemical recurrence in 12% of patients younger than 70 years old and in 25% of patients older than 70 years old.…”

Section: The Influence Of Age On Survival Outcomesmentioning

confidence: 99%

Correlations between age, Charlson score and outcome in clinical unilateral T3a prostate cancer

Hsu¹,

Joniau²,

Oyen³

et al. 2008

Asian J Androl

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show abstract

“…Data on the prognostic role of this parameter are controversial. The previous papers of the 70s showed more aggressive PCa in younger men [14,15] , while Kerr and Zincke [16] and more recently Obek et al [17] reported the presence of more aggressive tumors in patients 1 70 years old with a higher incidence of poorly differentiated cancer, positive surgical margin and seminal vesicle invasion. In our selected patients with OC PCa, age did not infl uence the risk of disease progression, as reported by Palisaar et al [6] .…”

Section: Discussionmentioning

confidence: 94%

Clinical and Pathological Characteristics of Patients Presenting with Biochemical Progression after Radical Retropubic Prostatectomy for Pathologically Organ-Confined Prostate Cancer

Pinto¹,

Prayer-Galetti²,

Gardiman

et al. 2006

Urol Int

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Introduction: To identify risk factors for biochemical failure after radical prostatectomy (RP) in men with pathologically organ-confined (OC) prostate cancer (PCa). Materials and Methods: Clinical and pathological features of 350 consecutive patients with pathologically OC PCa treated only with RP and bilateral pelvic lymphadenectomy were analyzed, retrospectively, to identify predictor parameters of prostate-specific antigen (PSA) failure (PSA ≧0.4 ng/ml). The median follow-up was 58.6 months (range: 3.9–183 months). All pathological specimens were step sectioned at 4-mm intervals. Kaplan-Meier progression-free survival rates and χ² test were adopted for statistical analyses. Multivariate Cox proportional hazard regression models were used to test the association between pathological Gleason score and surgical margin status. Results: 67 patients (19.1%) failed at a median follow-up of 40.2 months (range 1.9–123.3). Age and preoperative PSA failed to reveal significance also in patients with serum PSA ≧20 ng/ml (p = 0.46). Patients with T3 clinical stage had a higher progression rate compared to T1C and T2 (43.5 vs. 27.8 and 17.3%, respectively) even if no high statistical significance was pointed out. Presence of perineural infiltration (p = 0.04) and prostatic apex infiltration (p = 0.74) in the prostatectomy specimens failed to reveal significance. A high pathological Gleason score (≧7; p = 0.0003) and surgical margin status (p < 0.0001) were shown to be the most powerful predictive parameters of biochemical progression. Conclusions: In patients with pathologically OC PCa the presence of a high pathological Gleason score and positive surgical margins appear to represent the most important factors for prediction of outcome following RP.

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“…Further, cancer patients aged ≥80 years had a higher rate of poorly differentiated tumors and a larger proportion of high-stage tumors than patients aged <80 years old [21]. Obek et al report a higher biochemical failure rate in 41 patients aged >70 years who underwent RP than in 460 patients aged ≤70 years old, as well as a shorter time until failure [22]. The results in the present study clearly indicate that patients >65 years old had an excellent pathology and prognostic outcome when they had a very early cancer at the initial diagnosis that fit within the criteria of the NCCN guidelines.…”

Section: Discussionmentioning

confidence: 99%

Pathologic and Prognostic Outcomes of Very Low- and Low-Risk Prostate Cancer According to the National Comprehensive Cancer Network Guidelines in Japanese Patients with Radical Prostatectomy

Takizawa¹,

Ohori²,

Ohno³

et al. 2016

JCT

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Background: The purpose of this study was to validate the treatment strategy for a cohort of Japanese patients with very low-risk (VLR) and low-risk (LR) prostate cancer according to the National Comprehensive Cancer Network (NCCN) guidelines. Methods: We studied 751 patients with T1-3N0M0 prostate cancer treated with radical prostatectomy at our institution between 2000 and 2012. Patients with neoadjuvant treatments were excluded. We retrospectively reviewed the clinical and pathological outcomes for patients with VLR or LR prostate cancers that were classified by NCCN guidelines. Results: We identified 45 patients with VLR and 137 with LR prostate cancer. Non-biochemical recurrence rate at 5-year for 45 patients with VLR was 86.9% and 81.2% for 137 patients with LR (p = 0.56). However, none of the 19 patients >65 years old with VLR progressed, while 19% of 26 patients ≤65 years old with VLR cancer, 14% of patients >65 years old with LR cancer, and 17% of patients ≤65 years old with LR cancer progressed during the follow-up period (p = 0.04, p = 0.04 and p = 0.05, respectively). In analyses of prostatectomy specimens, both VLR and LR had similarly favorable outcomes, but patients >65 years old with VLR had the smallest tumors, with a mean of 5 mm in diameter. Conclusions: Our results support the treatment strategy of the NCCN that patients with VLR cancer and age >65 years old are good candidates for active surveillance, and that other treatment options-including active surveillance and aggressive treatments-can be applied to the remaining patients with VLR or LR cancers.

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Age as a prognostic factor for disease recurrence after radical prostatectomy

Cited by 35 publications

References 27 publications

Correlations between age, Charlson score and outcome in clinical unilateral T3a prostate cancer

Correlations between age, Charlson score and outcome in clinical unilateral T3a prostate cancer

Clinical and Pathological Characteristics of Patients Presenting with Biochemical Progression after Radical Retropubic Prostatectomy for Pathologically Organ-Confined Prostate Cancer

Pathologic and Prognostic Outcomes of Very Low- and Low-Risk Prostate Cancer According to the National Comprehensive Cancer Network Guidelines in Japanese Patients with Radical Prostatectomy

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