Survival Differences in High-Risk Prostate Cancer by Age

• Published in: Urology journal Vol. 20; no. 4; pp. 215 - 221
• Main Authors: García Fuentes, Clara, Guijarro, Ana, Hernández, Virginia, Gonzalo, Álvaro, Jiménez, Estíbaliz, De la Peña, Enrique, Pérez, Elia, Llorente, Carlos
• Format: Journal Article
• Language: English
• Published: Iran Urology and Nephrology Research Center 26.07.2023
• Subjects: Age; Aged; Humans; Male; Multivariate analysis; Prostate cancer; Prostate-Specific Antigen; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Radiation therapy; Retrospective Studies; Survival analysis; Survival Rate
• ISSN: 1735-1308; 1735-546X
• DOI: 10.22037/uj.v20i.7393

Age is an established determining factor in survival in low-risk prostate cancer (PC), being this evidence weaker in high-risk tumors. Our aim is to evaluate the survival of patients with high-risk PC treated with curative intent and to identify differences across ages at diagnosis. We did a retrospective analysis of patients with high-risk PC treated with surgery (RP) or radiotherapy (RDT) excluding N+ patients. We divided patients by age groups: < 60, 60-70, and > 70 years. We performed a comparative survival analysis. A multivariate analysis adjusted for clinically relevant variables and initial treatment received was performed. Of a total of 2383 patients, 378 met the selection criteria with a median follow-up of 8.9 years: 38 (10.1%) < 60 years, 175 (46.3%) between 60-70 years, and 165 (43.6%) >70 years. Initial treatment with surgery was predominant in the younger group (RP:63.2%, RDT:36.8%), and with radiotherapy in the older group (RP:17%, RDT:83%) (p = 0.001). In the survival analysis, significant differences were observed in overall survival, with better results for the younger group. However, these results were reversed in biochemical recurrence-free survival, with patients < 60 years presenting a higher rate of biochemical recurrence at 10 years. In the multivariate analysis, age behaved as an independent risk variable only for overall survival, with a HR of 2.8 in the group >70 years (95%CI: 1.22-6.5; p = 0.015). In our series, age appeared to be an independent prognostic factor for overall survival, with no differences in the rest of the survival rates.