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

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

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. © 2020, Springer Nature Switzerland AG.
Original languageEnglish
Pages (from-to)283-290
Number of pages8
JournalCancer Causes Control
Volume31
Issue number3
DOIs
Publication statusPublished - 2020
Externally publishedYes

Keywords

  • Local treatment
  • Radical prostatectomy
  • Radiotherapy
  • Survival
  • prostate specific antigen
  • adult
  • African American
  • age distribution
  • aged
  • Article
  • cancer incidence
  • cancer mortality
  • cancer radiotherapy
  • cancer risk
  • cancer staging
  • Caucasian
  • cohort analysis
  • ethnicity
  • follow up
  • human
  • major clinical study
  • male
  • population research
  • prediction
  • priority journal
  • prostate cancer
  • prostatectomy
  • risk assessment
  • age
  • cancer registry
  • epidemiology
  • ethnology
  • incidence
  • middle aged
  • mortality
  • pathology
  • prostate
  • prostate tumor
  • regression analysis
  • risk factor
  • survival rate
  • United States
  • African Americans
  • Age Factors
  • Aged
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prostate
  • Prostatectomy
  • Prostatic Neoplasms
  • Regression Analysis
  • Risk Factors
  • SEER Program
  • Survival Rate

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