A Comparison by Age of Death Rates due to Prostate Cancer Alone

Cook, Galen B.; Watson, Francis R.

doi:10.1016/s0022-5347(17)62594-1

Cited by 27 publications

(10 citation statements)

References 8 publications

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“…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: 93%

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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Section: Discussionmentioning

confidence: 93%

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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“…In several series, onset of disease at a young age has been correlated with more aggressive tumor types and subsequent mortality. [29][30][31][32] Conversely, other studies have shown survival rates among younger patients to be equivalent or even superior to those of elderly patients. 33,34 A recent meta-analysis of the negative impact of young age on prostate cancer mortality identified 34 studies of 27 551 patients from the Medline Database between 1966 and 2000.…”

Section: Effect Of Age On Prognosismentioning

confidence: 99%

The impact of age and comorbidity on survival outcomes and treatment patterns in prostate cancer

Hall

Jani

Ryu

et al. 2005

Prostate Cancer Prostatic Dis

123

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The management of localized prostate cancer is based on stage, grade, PSA, and subjective assessment of comorbidity and life expectancy. Over the last 15 y, stage migration and the improved use of Gleason sum, PSA and TNM staging have led to many treatment options for patients with newly diagnosed localized prostate cancer. At the same time, advances in treatment techniques have helped decrease the long-term complications of surgery and radiotherapy. However, the importance of age and comorbidity, in survival outcomes and treatment decision-making has been largely overlooked. Currently, stage, grade, and PSA are the only quantifiable variables consistently used in research and treatment decision-making. Comorbidity and life expectancy have remained largely subjective variables. Increasing longevity and a rapidly aging population have made age and comorbidity increasingly important factors in clinical research and treatment decision-making. This article reviews the importance of age and comorbidity on treatment decisions and survival outcomes in prostate cancer, as well as their use as objectively quantifiable variables. Examples from the general oncology literature are given. The overview also examines validated comorbidity indices and advocates the use of the Charlson Comorbidity Index (CCI) in research outcomes and treatment decision-making in prostate cancer. Several clinical vignettes are provided to demonstrate the potential clinical utility of the CCI as applied to prostate cancer.

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“…Controversy exists regarding the importance of patient age in disease behavior of prostate cancer. In several series, younger age at diagnosis has been correlated with more aggressive tumor types and subsequent mortality [18, 19]. Conversely, other studies have shown survival rates among younger patients to be equivalent or even superior to those of elderly patients [20–22].…”

Section: Discussionmentioning

confidence: 99%

Younger Age Is an Independent Predictor for Poor Survival in Patients with Signet Ring Prostate Carcinoma

Wang

Hemstreet

2011

Prostate Cancer

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Objective. The aim of this study was to examine the epidemiology, natural history, treatment pattern, and predictors of long-term survival of signet ring prostate carcinoma (SRPC) patients based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. Methods & Results. Between 1980 and 2004, a total of 93 patients with pathologically confirmed SRPC were identified. The mean age was 70 ± 11 years old. 82.8% of the patients had poorly or undifferentiated histology grade. 13.9% patients presented with metastatic disease. The 1-, 3-, and 5-year cancer-specific survival rates were 94.6%, 89.6%, and 83.8%, respectively. Using multivariate Cox proportional hazard model, younger age (40–50 versus age >70 yrs, P = .01), advanced tumor stage (distant versus local/regional, P = .02), and earlier diagnosis year (before 1995 versus after 1995, P = .01) were predictors of worse cancer specific survival. Conclusions. Despite more aggressive cancer therapy, younger SRPC patients had a worse cancer specific survival. This information could be useful when counseling these patients and emphasizes the need for new strategies and molecular-based therapeutic approaches for younger patients with SRPC.

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A Comparison by Age of Death Rates due to Prostate Cancer Alone

Cited by 27 publications

References 8 publications

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

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

The impact of age and comorbidity on survival outcomes and treatment patterns in prostate cancer

Younger Age Is an Independent Predictor for Poor Survival in Patients with Signet Ring Prostate Carcinoma

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