Pathological and Oncological Outcomes of Elderly Men with Clinically Localized Prostate Cancer

The aim of the study was to characterize pathological and oncological outcomes of elderly men with clinically localized prostate cancer treated with radical prostatectomy. Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to whether they were of age 70 or 70 years at radical prostatectomy. Patient characteristics, pathological and oncological outcomes were compared among the groups. Of the total population, 31.4 (398 of 1268) of patients were 70 years of age. The median age in patients 70 and 70 years of age was 64 (4569) and 72 (7083) years. The proportion of low-risk disease was significantly lower among those 70 years of age than in those 70 years, while the proportion of high-risk disease was significantly higher among those 70 years of age than in those 70 years (P 0.001). The proportions of pathological high-risk disease (T3b, GS 8, positive surgical margin or lymph node invasion) in patients 70 and 70 years of age were 42.0 and 50.0, respectively (P 0.008). The proportions of organ-confined disease in patients 70 and 70 years of age were 69.9 and 65.1, respectively (P 0.09). With a median follow-up of 50 months, 5-year biochemical recurrence-free and cancer-specific survival rates were not significantly different among the groups. Radical prostatectomy was more likely to be performed in those with higher-risk disease among patients 70 years of age. About half of the patients 70 years of age had pathological, high-risk disease. Radical prostatectomy could be considered for patients with expected long-term life expectancy, even in the setting of advanced age.