Survival of men with clinically localized prostate cancer treated with prostatectomy, brachytherapy, or no definitive treatment

Abstract

BACKGROUND.The optimal treatment for men with early stage prostate cancer remains undefined. Survival of such patients after surgery, brachytherapy, or no definitive therapy was investigated specifically to determine the impact of age at diagnosis.METHODS.In all, 60,290 men diagnosed with organ‐confined, low and moderate grade prostate cancer between 1988 and 2002 were retrospectively identified from centers participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Prostate cancer‐specific mortality (PCSM) and any‐cause mortality (ACM) were determined. Outcomes for patients treated by brachytherapy, surgery, or receiving no definitive treatment were compared using the Wilcoxon test, stratified by T‐stage and grade, and using multivariate analysis.RESULTS.The median follow‐up time was 46 months (range, 0–189 months). For men under age 60 at diagnosis, PCSM at 10 years was 1.3%, 0.5%, and 3.7% for surgery, brachytherapy, and no definitive therapy, respectively. For men age 60 and older the PCSM was 3.8%, 5.3%, and 8.4%, respectively. On univariate and multivariate analysis, surgery and brachytherapy resulted in statistically equivalent PCSM and ACM, and both had a significantly lower PCSM and ACM versus no definitive therapy.CONCLUSIONS.A better survival was observed in men treated with a definitive therapy. The magnitude of the benefit on PCSM or ACM was similar for both definitive therapies irrespective of age. Cancer 2006. © 2006 American Cancer Society.

Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy

“…21 However, there are conflicting studies which do not clearly show age to be a prognostic factor for prostate cancer specific survival, particularly in patients with high Gleason grade. [21][22][23] In our study, in multivariate analysis of patients with GS 9-10 tumors, while the effect of age (P = 0.068) only trended toward significance, aspirin remained a highly statistically significant predictor of overall survival (P = 0.036). Thus, while our sample size precludes definite conclusions, it is unlikely that age was responsible for the highly statistically significant survival advantage in patients with GS 9-10 who took aspirin.…”

High-Throughput Transcriptomic Analysis Nominates Proteasomal Genes As Age Specific Biomarkers and Therapeutic Targets in Prostate Cancer

“…4,5 However, clinical findings to support this notion have to date been mixed. [6][7][8][9][10][11][12][13][14] Independent of the prognosis of early versus late-life onset PCa, it is possible that the biological pathways that drive this disease differ by age. However, to date, there have been no studies examining the similarities and differences in the prognostic drivers of PCa in different age groups.…”

Radical Prostatectomy Versus Radiation and Androgen Deprivation Therapy for Clinically Localized Prostate Cancer: How Good Is the Evidence?

“…Using the selection criteria just described, a total of 14 studies were identified for inclusion in this analysis (4,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). One of them was subsequently noted to be only partially analyzable because we were unable to determine the CSS (29).…”