Prostate cancer disease-free survival after radical retropubic prostatectomy in patients older than 70 years compared to younger cohorts

Bahaa S. Malaeb, Hani H. Rashid, Yair Lotan, Seyyed M. Khoddami, Shahrokh F. Shariat, Arthur I Sagalowsky, John D. McConnell, Claus Roehrborn, Kenneth S. Koeneman

Research output: Contribution to journalArticle

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Abstract

Objectives: To evaluate the feasibility of radical retropubic prostatectomy (RRP) as an option for treating men older than 70 years with organ confined prostate cancer and to compare biochemical progression-free survival with younger cohorts. Materials and Methods: A total of 689 consecutive patients who were treated with RRP from 1994 to 2002 for clinically localized prostate cancer were categorized into 3 different age groups: younger than 50 years (n = 49), 50-70 years (n = 601), and older than 70 years (n = 39). Patients older than 70 years were healthy individuals for their age. Preoperative and postoperative cancer-specific characteristics were compared among these 3 groups. Results: There was no statistical significant difference among the 3 age strata in terms of clinical parameters (prostate-specific antigen, Gleason score, clinical stage, percent and number of positive biopsy cores) and pathologic findings (surgical margin, lymph node status, extracapsular extension, lymphovascular invasion, and pathologic Gleason score). The rate of seminal vesicle invasion and prostate volume increased with advancing age (P = 0.034 and P < 0.001). In multivariate logistic regression analysis, age was not associated with seminal vesicle invasion. The 5-year prostate-specific antigen progression-free estimates for patients younger than 50, 50-70, and older than 70 years were 82% (95% confidence interval [CI] 69% to 96%), 82% (95% CI 78% to 86%), and 65% (95% CI 43% to 86%), respectively (P = 0.349). The overall and cause-specific mortalities were not different. Conclusions: RRP could be considered a standard treatment option in men older than 70 years with localized prostate cancer. Further studies are necessary to assess the survival benefit and health-related quality of life after radical prostatectomy versus watchful waiting in patients older than 70 years.

Original languageEnglish (US)
Pages (from-to)291-297
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume25
Issue number4
DOIs
StatePublished - Jul 2007

Fingerprint

Prostatectomy
Disease-Free Survival
Prostatic Neoplasms
Neoplasm Grading
Seminal Vesicles
Confidence Intervals
Prostate-Specific Antigen
Watchful Waiting
Prostate
Age Groups
Logistic Models
Lymph Nodes
Regression Analysis
Quality of Life
Biopsy
Survival
Mortality
Neoplasms
Therapeutics

Keywords

  • Biochemical recurrence
  • Life expectancy
  • Prostate cancer
  • Radical retropubic prostatectomy
  • Watchful waiting

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Prostate cancer disease-free survival after radical retropubic prostatectomy in patients older than 70 years compared to younger cohorts. / Malaeb, Bahaa S.; Rashid, Hani H.; Lotan, Yair; Khoddami, Seyyed M.; Shariat, Shahrokh F.; Sagalowsky, Arthur I; McConnell, John D.; Roehrborn, Claus; Koeneman, Kenneth S.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 25, No. 4, 07.2007, p. 291-297.

Research output: Contribution to journalArticle

Malaeb, Bahaa S. ; Rashid, Hani H. ; Lotan, Yair ; Khoddami, Seyyed M. ; Shariat, Shahrokh F. ; Sagalowsky, Arthur I ; McConnell, John D. ; Roehrborn, Claus ; Koeneman, Kenneth S. / Prostate cancer disease-free survival after radical retropubic prostatectomy in patients older than 70 years compared to younger cohorts. In: Urologic Oncology: Seminars and Original Investigations. 2007 ; Vol. 25, No. 4. pp. 291-297.
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abstract = "Objectives: To evaluate the feasibility of radical retropubic prostatectomy (RRP) as an option for treating men older than 70 years with organ confined prostate cancer and to compare biochemical progression-free survival with younger cohorts. Materials and Methods: A total of 689 consecutive patients who were treated with RRP from 1994 to 2002 for clinically localized prostate cancer were categorized into 3 different age groups: younger than 50 years (n = 49), 50-70 years (n = 601), and older than 70 years (n = 39). Patients older than 70 years were healthy individuals for their age. Preoperative and postoperative cancer-specific characteristics were compared among these 3 groups. Results: There was no statistical significant difference among the 3 age strata in terms of clinical parameters (prostate-specific antigen, Gleason score, clinical stage, percent and number of positive biopsy cores) and pathologic findings (surgical margin, lymph node status, extracapsular extension, lymphovascular invasion, and pathologic Gleason score). The rate of seminal vesicle invasion and prostate volume increased with advancing age (P = 0.034 and P < 0.001). In multivariate logistic regression analysis, age was not associated with seminal vesicle invasion. The 5-year prostate-specific antigen progression-free estimates for patients younger than 50, 50-70, and older than 70 years were 82{\%} (95{\%} confidence interval [CI] 69{\%} to 96{\%}), 82{\%} (95{\%} CI 78{\%} to 86{\%}), and 65{\%} (95{\%} CI 43{\%} to 86{\%}), respectively (P = 0.349). The overall and cause-specific mortalities were not different. Conclusions: RRP could be considered a standard treatment option in men older than 70 years with localized prostate cancer. Further studies are necessary to assess the survival benefit and health-related quality of life after radical prostatectomy versus watchful waiting in patients older than 70 years.",
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T1 - Prostate cancer disease-free survival after radical retropubic prostatectomy in patients older than 70 years compared to younger cohorts

AU - Malaeb, Bahaa S.

AU - Rashid, Hani H.

AU - Lotan, Yair

AU - Khoddami, Seyyed M.

AU - Shariat, Shahrokh F.

AU - Sagalowsky, Arthur I

AU - McConnell, John D.

AU - Roehrborn, Claus

AU - Koeneman, Kenneth S.

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N2 - Objectives: To evaluate the feasibility of radical retropubic prostatectomy (RRP) as an option for treating men older than 70 years with organ confined prostate cancer and to compare biochemical progression-free survival with younger cohorts. Materials and Methods: A total of 689 consecutive patients who were treated with RRP from 1994 to 2002 for clinically localized prostate cancer were categorized into 3 different age groups: younger than 50 years (n = 49), 50-70 years (n = 601), and older than 70 years (n = 39). Patients older than 70 years were healthy individuals for their age. Preoperative and postoperative cancer-specific characteristics were compared among these 3 groups. Results: There was no statistical significant difference among the 3 age strata in terms of clinical parameters (prostate-specific antigen, Gleason score, clinical stage, percent and number of positive biopsy cores) and pathologic findings (surgical margin, lymph node status, extracapsular extension, lymphovascular invasion, and pathologic Gleason score). The rate of seminal vesicle invasion and prostate volume increased with advancing age (P = 0.034 and P < 0.001). In multivariate logistic regression analysis, age was not associated with seminal vesicle invasion. The 5-year prostate-specific antigen progression-free estimates for patients younger than 50, 50-70, and older than 70 years were 82% (95% confidence interval [CI] 69% to 96%), 82% (95% CI 78% to 86%), and 65% (95% CI 43% to 86%), respectively (P = 0.349). The overall and cause-specific mortalities were not different. Conclusions: RRP could be considered a standard treatment option in men older than 70 years with localized prostate cancer. Further studies are necessary to assess the survival benefit and health-related quality of life after radical prostatectomy versus watchful waiting in patients older than 70 years.

AB - Objectives: To evaluate the feasibility of radical retropubic prostatectomy (RRP) as an option for treating men older than 70 years with organ confined prostate cancer and to compare biochemical progression-free survival with younger cohorts. Materials and Methods: A total of 689 consecutive patients who were treated with RRP from 1994 to 2002 for clinically localized prostate cancer were categorized into 3 different age groups: younger than 50 years (n = 49), 50-70 years (n = 601), and older than 70 years (n = 39). Patients older than 70 years were healthy individuals for their age. Preoperative and postoperative cancer-specific characteristics were compared among these 3 groups. Results: There was no statistical significant difference among the 3 age strata in terms of clinical parameters (prostate-specific antigen, Gleason score, clinical stage, percent and number of positive biopsy cores) and pathologic findings (surgical margin, lymph node status, extracapsular extension, lymphovascular invasion, and pathologic Gleason score). The rate of seminal vesicle invasion and prostate volume increased with advancing age (P = 0.034 and P < 0.001). In multivariate logistic regression analysis, age was not associated with seminal vesicle invasion. The 5-year prostate-specific antigen progression-free estimates for patients younger than 50, 50-70, and older than 70 years were 82% (95% confidence interval [CI] 69% to 96%), 82% (95% CI 78% to 86%), and 65% (95% CI 43% to 86%), respectively (P = 0.349). The overall and cause-specific mortalities were not different. Conclusions: RRP could be considered a standard treatment option in men older than 70 years with localized prostate cancer. Further studies are necessary to assess the survival benefit and health-related quality of life after radical prostatectomy versus watchful waiting in patients older than 70 years.

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KW - Life expectancy

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KW - Watchful waiting

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