The Relationship Between Age At Time Of Surgery And Risk Of Biochemical Failure After Radical Prostatectomy

Main Category: Prostate / Prostate Cancer
Also Included In: Men's health;  Urology / Nephrology
Article Date: 28 Jan 2010 - 1:00 PDT

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UroToday.com - In the online edition of the British Journal of Urology International, a group from Columbia University Department of Urology report that older men undergoing radical prostatectomy (RP) for prostate cancer (CaP) do not have an increased risk of disease recurrence in the multivariate context that includes PSA level, Gleason score and clinical stage.

The study is a single institutional retrospective study of 1,983 men who underwent RP between 1988 and 2008. Men ages 40-64 formed one group, based upon preliminary assessment that biochemical failure among these men when further sub-stratified was not different. This group was compared to an older group of men age 65 and above. Biochemical recurrence was defined as a PSA level of >0.2ng/ml and recurrence free survival (RFS) rates were calculated. Univariate and multivariate analysis was performed using clinical and pathological variables.

The younger group contained 1,325 patients and the older group 659 patients. The mean ages in the younger and older cohorts were 57.7 and 68.5 years, respectively. The mean pre-operative PSA levels for the younger and older groups were 7.9 and 8.6ng/ml, respectively. Most men in both groups had low-risk CaP. Duration of follow-up was similar at 50.2 and 56.3 months. The 5-year RFS rates were 80.6% and 75.6% for the younger and older men, respectively. In univariate analysis, age >65 years was a significant predictor of PSA recurrence risk with a hazard ration of 1.30. The HR was increased to 1.47 for low risk disease, and was not significant for intermediate or high-risk disease. In multivariate analysis age >65 years PSA level, Gleason score and clinical stage but not age were independent predictors of recurrence.

Barlow LJ, Badalato GM, Bashir T, Benson MC, McKiernan JM

BJU Int. 2009 Oct 26. Epub ahead of print.
doi:10.1111/j.1464-410X.2009.08977.x

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

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