Purpose: To test the effect of age on cancer-specific mortality (CSM) in most contemporary prostate cancer (PCa) patients of all stages and across all treatment modalities. Methods: Within the Surveillance, Epidemiology, and End Results database (2004–2016), we identified 579,369 PCa patients. Cumulative incidence plots and multivariable competing-risks regression analyses (MCR) were used. Subgroup analyses were performed according to ethnicity (African-Americans), clinical stage (T1-2N0M0, T3-4N0M0, TanyN1M0, and TanyNanyM1), as well as treatment modalities. Results: Patient distribution was as follows: 142,338 (24.6%) < 60 years; 113,064 (19.5%) 60–64 years; 127,158 (21.9%) 65–69 years; 94,782 (16.4%) 70–74 years; and 102,027 (17.6%) ≥ 75 years. Older patients harbored worse tumor characteristics and more frequently received no local treatment. Overall, 10-year CSM rates were 4.8, 5.3, 5.9, 7.6, and 14.6%, respectively, in patients aged < 60, 60–64, 65–69, 70–74 ,and ≥ 75 years (p < 0.001). In MCR focusing on the overall cohort and T1-2N0M0 patients, older age independently predicted higher CSM, but not in T3-4N0-1M0-1 patients. Conclusions: Older age was associated with higher grade and stage and independently predicted higher CSM in T1-2N0M0 patients, but not in higher stages. Differences in diagnostics and therapeutics seem to affect elderly patients within T1-2N0M0 PCa and should be avoided if possible.

The effect of age on cancer-specific mortality in patients with prostate cancer : a population-based study across all stages / S. Knipper, A. Pecoraro, C. Palumbo, G. Rosiello, S. Luzzago, M. Deuker, Z. Tian, S.F. Shariat, F. Saad, D. Tilki, M. Graefen, P.I. Karakiewicz. - In: CANCER CAUSES & CONTROL. - ISSN 0957-5243. - 31:3(2020), pp. 283-290. [10.1007/s10552-020-01273-5]

The effect of age on cancer-specific mortality in patients with prostate cancer : a population-based study across all stages

S. Luzzago;
2020

Abstract

Purpose: To test the effect of age on cancer-specific mortality (CSM) in most contemporary prostate cancer (PCa) patients of all stages and across all treatment modalities. Methods: Within the Surveillance, Epidemiology, and End Results database (2004–2016), we identified 579,369 PCa patients. Cumulative incidence plots and multivariable competing-risks regression analyses (MCR) were used. Subgroup analyses were performed according to ethnicity (African-Americans), clinical stage (T1-2N0M0, T3-4N0M0, TanyN1M0, and TanyNanyM1), as well as treatment modalities. Results: Patient distribution was as follows: 142,338 (24.6%) < 60 years; 113,064 (19.5%) 60–64 years; 127,158 (21.9%) 65–69 years; 94,782 (16.4%) 70–74 years; and 102,027 (17.6%) ≥ 75 years. Older patients harbored worse tumor characteristics and more frequently received no local treatment. Overall, 10-year CSM rates were 4.8, 5.3, 5.9, 7.6, and 14.6%, respectively, in patients aged < 60, 60–64, 65–69, 70–74 ,and ≥ 75 years (p < 0.001). In MCR focusing on the overall cohort and T1-2N0M0 patients, older age independently predicted higher CSM, but not in T3-4N0-1M0-1 patients. Conclusions: Older age was associated with higher grade and stage and independently predicted higher CSM in T1-2N0M0 patients, but not in higher stages. Differences in diagnostics and therapeutics seem to affect elderly patients within T1-2N0M0 PCa and should be avoided if possible.
Local treatment; Radical prostatectomy; Radiotherapy; Survival; African Americans; Age Factors; Aged; Humans; Incidence; Male; Middle Aged; Prostate; Prostatectomy; Prostatic Neoplasms; Regression Analysis; Risk Factors; SEER Program; Survival Rate; United States
Settore MED/24 - Urologia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/881567
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