Men Older Than 70 Years Have Higher Risk Prostate Cancer and Poorer Survival in the Early and Late Prostate Specific Antigen Eras

Sun, Leon; Caire, Arthur; Robertson, Cary N.; George, Daniel J.; Polascik, Thomas J.; Maloney, Kelly E.; Walther, Philip; Stackhouse, Danielle A.; Lack, Benjamin D; Albala, David; Moul, Judd W.

doi:10.1016/j.juro.2009.07.034

Cited by 84 publications

(62 citation statements)

References 18 publications

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“…34,35 On the other hand, other studies show that survival among younger patients was equivalent or even higher than older patients. 36,37 The median age of patients undergoing brachytherapy in this study was higher than that of the patients operated on (p=0.001), showing a current tendency of recommending this treatment only to older patients that cannot undergo surgery. In practice, the patient's age is often considered when choosing the treatment in cases of localized prostate cancer.…”

Section: Resultsmentioning

confidence: 62%

Brachytherapy and radical prostatectomy in patients with early prostate cancer

Ferreira

Guerra

Lopes

et al. 2015

Rev. Assoc. Med. Bras.

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Methods: all had prostate-specific antigen, Gleason scores and clinical stage recorded prior to treatment. Biochemical relapse was defined as prostate-specific antigen (PSA)>0.4ng/mL for radical prostatectomy, and any elevation equal or higher than 2ng/mL over the PSA nadir for implanted patients. To analyze the effect of treatment on biochemical recurrence-free survival (BRFS), Kaplan-Meier curves and Cox regression were generated. Mean follow-up time was 56.1 months for patients with the implant, and 26.6 months for those operated on. BRFS in 5 years was 69% (95% CI: 58.18-77.45) for the whole cohort. Discussion: when stratified according to treatment, survival of patients who had undergone brachytherapy (79.70%) was higher to those operated on (44.30%; pvalue=0.0056). Upon multivariate analysis, independent predictors were iPSA (HR: 2.91, 95% CI: 1,32-6,42), Gleason score (HR: 2.18, 95% CI: 1,00-4,81) and treatment modality (HR: 2.61, 95% CI: 1.18-5,75). Risk of biochemical failure was higher with surgery than brachytherapy, which may be related to the failure criteria adopted, which is different for each therapy, as well as the high rate of histological progression between preoperative prostate biopsy and surgical specimen. Conclusion: it was found that brachytherapy is a good therapeutic option for low risk prostate cancer.

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Section: Resultsmentioning

confidence: 62%

Brachytherapy and radical prostatectomy in patients with early prostate cancer

Ferreira

Guerra

Lopes

et al. 2015

Rev. Assoc. Med. Bras.

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“…Da mesma forma, também se verificou aumento das taxas de mortalidade por câncer de próstata no Estado de São Paulo, no período de 1970 a 1992 24 , e no Rio Grande do Sul, no período de 1979 a 1995 25 . Como hipótese explicativa para esses resultados, é importante destacar que a expansão e a melhoria das técni-cas de diagnóstico precoce, como o rastreamento pela dosagem sérica do antígeno prostático específico (PSA), podem ter conduzido a uma maior precocidade na detecção desta neoplasia maligna, que outrora poderia permanecer não diagnosticada 26 . Além disso, é importante considerar que a maior longevidade e controle das demais doenças crônico-degenerativas, como a hipertensão e o diabetes, por exemplo, contribuem para a maior exposição ao risco de desenvolver e morrer por câncer de próstata.…”

Section: Resultsunclassified

Tendência da mortalidade por neoplasias malignas selecionadas em Rio Branco, Acre, Brasil, 1980-2006

Nakashima

Koifman

2011

Cad. Saúde Pública

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A distribuição temporal da incidência e mortalidade por câncer na Amazônia Ocidental é desconhecida. As tendências das taxas de mortalidade por câncer ajustadas por idade nas localizações anatômicas apresentando maior magnitude entre 1980-2006 em Rio Branco, Acre, Brasil, foram modelizadas por meio de regressão linear. A tendência temporal da mortalidade por câncer em homens revelou padrão de crescimento não constante, e estabilidade em mulheres. Ao final da série, as taxas mais elevadas em mulheres foram, em ordem decrescente, colo uterino, pulmão, fígado e vias biliares intra-hepáticas, estômago e mama. No sexo masculino, foram pulmão, próstata, fígado e vias biliares intra-hepáticas, estômago e esôfago. O padrão observado revela elevação na mortalidade por câncer de mama e pulmão em mulheres, declínio de câncer de colo uterino, pulmão em homens, e estômago em ambos os sexos. A elevada mortalidade por câncer de fígado merece destaque em decorrência das elevadas taxas de infecção pelo vírus da hepatite B e C no Acre.

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“…Although neither the frequency of low testosterone nor the mean testosterone level were distinctive, the risk of high-grade prostate cancer in men aged >70 years was significant. It seems that older age is an important risk factor for highgrade prostate cancer [27].…”

Section: Discussionmentioning

confidence: 99%

Low testosterone level is an independent risk factor for high‐grade prostate cancer detection at biopsy

et al. 2015

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ObjectiveTo investigate the relationship between low testosterone levels and prostate cancer detection risk in a biopsy population. Patients and MethodsIn all, 681 men who underwent initial 12-core transrectal prostate biopsy at our institution were included in this retrospective study. Patients were divided into groups with low (<300 ng/dL) and normal testosterone levels (≥300 ng/ dL). Clinical and pathological data were analysed. ResultsAmong 681 men, 86 men (12.6%) had low testosterone levels, 143 (32.7%) had a positive biopsy, and 99 (14.5%) had highgrade prostate cancer. The mean age, prostate-specific antigen (PSA) level, PSA density, body mass index (BMI), number of abnormal digital rectal examination (DRE) findings, and diabetes mellitus (DM) history were significantly different between the low and normal level testosterone groups. A low testosterone level was significantly associated with a higher risk of detection of overall prostate cancer than a normal testosterone level in univariate analysis (odds ratio [OR] 2.545, P = 0.001), but not in multivariate analysis adjusting for parameters such as age, PSA, prostate volume, BMI, abnormal DRE findings and DM (OR 1.583, P = 0.277). Meanwhile, a low testosterone level was significantly related to a higher rate of high-grade prostate cancer compared with a normal testosterone level in univariate (OR 3.324, P < 0.001) and multivariate analysis adjusting for other parameters (OR 2.138, P = 0.035). ConclusionLow testosterone level is an independent risk factor for highgrade prostate cancer detection at biopsy. Therefore, checking testosterone levels could help to determine whether prostate biopsy should be carried out.

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Men Older Than 70 Years Have Higher Risk Prostate Cancer and Poorer Survival in the Early and Late Prostate Specific Antigen Eras

Cited by 84 publications

References 18 publications

Brachytherapy and radical prostatectomy in patients with early prostate cancer

Brachytherapy and radical prostatectomy in patients with early prostate cancer

Tendência da mortalidade por neoplasias malignas selecionadas em Rio Branco, Acre, Brasil, 1980-2006

Low testosterone level is an independent risk factor for high‐grade prostate cancer detection at biopsy

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