Poor Overall Survival In Septa- And Octogenarian Patients After Radical Prostatectomy And Radiotherapy For Prostate Cancer

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology;  Radiology / Nuclear Medicine
Article Date: 07 Aug 2008 - 1:00 PDT

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UroToday.com - In the online issue of European Urology, Dr. Claudio Jeldres and a group of international investigators addressed the overall survival of septa- and octogenarians who underwent radical prostatectomy (RP) or radiotherapy (XRT) for prostate cancer (CaP). The Quebec Health Plan database was used to identify 6,183 men treated with RP or XRT for CaP between 1989 and 2000. The database contained no information on tumor stage or grade, PSA levels, or cause-specific mortality. The researchers controlled for the potential effect of CaP-specific mortality by performing an analysis in a subset of individuals who did not receive any secondary therapy.

Of the 6,138 patients age 70 or older, 1,591 (25.7%) underwent RP and 4,592 (74.3%) were treated with XRT. The median actuarial survival for the entire group was 7.4 years. For the RP patients it was 12.1 years, compared to 5.7 years after XRT. Analyses using life tables identified 10-year survival probability at 38.5%. At 10 years after RP overall survival was 59.3% compared to 30.3% after XRT. The data suggested that 10 years after treatment, 83.6% of RP patients and 69.9% of XRT patients were free of secondary therapy. The risk of overall mortality was 2.1-fold higher in XRT treated patients. Androgen-deprivation therapy exerted a protective effect on survival for XRT patients.

They reported that 62.5%, 44%, and 19.1% of RP patients ages 70-74, 75-79, and 80 or older survived beyond 10 years. The percentages for XRT-treated men were 37.9%, 24.8%, and 9.4% respectively.

The investigators concluded that in this study cohort, 40% of patients who underwent RP and 70% of men who underwent XRT would not have had adequate life expectancy to have warranted attempted curative therapy.

Jeldres C, Suardi N, Walz J, Saad F, Hutterer GC, Bhojani N, Shariat SF, Perrotte P, Graefen M, Montorsi F, Karakiewicz PI
Eur Urol. 2008 Jul;54(1):107-17
10.1016/j.eururo.2007.10.038

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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