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

Sophie Knipper, Angela Pecoraro, Carlotta Palumbo, Giuseppe Rosiello, Stefano Luzzago, Marina Deuker, Zhe Tian, Shahrokh F. Shariat, Fred Saad, Derya Tilki, Markus Graefen, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
JournalCancer Causes and Control
DOIs
Publication statusAccepted/In press - Jan 1 2020
Externally publishedYes

Keywords

  • Local treatment
  • Radical prostatectomy
  • Radiotherapy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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