Effects of radical prostatectomy on survival in elderly patients aged 75 years and over
10.3760/cma.j.issn.0254-9026.2019.03.013
- VernacularTitle:前列腺癌根治术对75岁及以上患者生存情况的影响
- Author:
Xiaoxiao GUO
1
,
2
;
Shengcai ZHU
;
Huimin HOU
;
Shengjie LIU
;
Dalei ZHANG
;
Pengjie WU
;
Jianye WANG
;
Ming LIU
Author Information
1. 北京医院泌尿科 国家老年医学中心 100730
2. 北京协和医学院 100730
- Keywords:
Prostate neoplasms;
Transurethral resection of prostate;
Survival analysis
- From:
Chinese Journal of Geriatrics
2019;38(3):278-282
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of radical prostatectomy on the overall survival (OS)and tumor-specific survival in prostate cancer(PCa)patients aged 75 years and older.Methods Clinical data of patients aged 75 and older with localized PCa from Surveillance,Epidemiology,and End Results(SEER)Database from 2004 to 2016 were retrospectively analyzed.There were 17 899 cases of PCa undergoing radical prostatectomy and 3 648 cases of PCa without surgery in this study.The OS and prostate cancer-specific survival(PSS)were compared between the surgery group and the nonsurgery group.Results For 75-79-year-old patients with high-risk localized PCa,the OS and PSS in the surgery group were better than in the non-surgery group (OR =1.49,95 ％ CI:1.22 ～ 1.82,P ＜ 0.01;OR=1.43,95％CI:1.09～2.04,P＜0.05).For patients aged 75-79 years with low-risk PCa and patients aged 80 years and older with low-,middle-,or high-risk PCa,the OS was worse in the surgery group than in the non-surgery group(OR =0.54,95％CI:0.38～0.76,P＜0.01;OR =0.47,95％CI:0.34～0.66,P＜0.01;OR =0.58,95％CI:0.44～0.78,P＜0.01;OR =0.59,95％CI:0.51 ～0.68,P＜0.01).For patients aged 75-79 years with low-or medium-risk PCa and patients aged 80 years and older with medium-risk PCa,there was no statistical difference in PSS between the surgery and non-surgery groups(P＞0.05).Conclusions Age limits for prostatectomy should be extended as a result of increasing average life expectancy.Patients aged 75-79 years with high-risk PCa can be considered for surgical treatment,while it should not be recommended for patients aged 75-79 years with low-or medium-risk localized PCa or aged more than 80 years.Many factors should be considered in making treatment decisions for prostate cancer.
