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The relationship between age at time of surgery and risk of biochemical failure after radical prostatectomy.
BJU Int. 2010 Jun; 105(12):1646-9.BI

Abstract

OBJECTIVES

To evaluate the effects of age at radical prostatectomy (RP) on recurrence-free survival (RFS) in patients with prostate cancer stratified by established preoperative risk factors (such as prostate-specific antigen (PSA) level, Gleason score, and tumour stage), as increasing age has been associated with more indolent behaviour in some cancers.

PATIENTS AND METHODS

A retrospective analysis of men treated with RP from 1988 to 2008 was conducted. Patients were divided into two groups by age at the time of RP, and RFS rates were analysed using Kaplan-Meier survival curves. The subgroups were stratified by preoperative PSA level, biopsy Gleason score, and clinical stage; multivariate analyses with Cox proportional hazards models were used to identify independent predictors of recurrence. Recurrence was defined as a single PSA level of > or =0.2 ng/mL at least 28 days after RP.

RESULTS

In all, 1984 patients met inclusion criteria and were divided into groups 1 (1325 men aged 40-64 years) and 2 (659 men aged > or =65 years). The 5-year RFS rates were 80.6% (confidence interval, CI 78.0-82.9%) and 75.6% (CI 71.5-79.1%) for groups 1 and 2, respectively. In the univariate model, advanced age was significantly associated with an increased overall risk of recurrence (hazard ratio, HR 1.30, P = 0.012). However, in multivariate analyses accounting for PSA level, Gleason score, and clinical stage, age was not an independent predictor of recurrence (HR 1.04, P = 0.76).

CONCLUSION

Older patients who undergo RP appear to have an increased risk of recurrence. However, age is not an independent predictor of recurrence when accounting for PSA level, grade, and stage.

Authors+Show Affiliations

Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. ljb2119@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19863523

Citation

Barlow, LaMont J., et al. "The Relationship Between Age at Time of Surgery and Risk of Biochemical Failure After Radical Prostatectomy." BJU International, vol. 105, no. 12, 2010, pp. 1646-9.
Barlow LJ, Badalato GM, Bashir T, et al. The relationship between age at time of surgery and risk of biochemical failure after radical prostatectomy. BJU Int. 2010;105(12):1646-9.
Barlow, L. J., Badalato, G. M., Bashir, T., Benson, M. C., & McKiernan, J. M. (2010). The relationship between age at time of surgery and risk of biochemical failure after radical prostatectomy. BJU International, 105(12), 1646-9. https://doi.org/10.1111/j.1464-410X.2009.08977.x
Barlow LJ, et al. The Relationship Between Age at Time of Surgery and Risk of Biochemical Failure After Radical Prostatectomy. BJU Int. 2010;105(12):1646-9. PubMed PMID: 19863523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between age at time of surgery and risk of biochemical failure after radical prostatectomy. AU - Barlow,LaMont J, AU - Badalato,Gina M, AU - Bashir,Talha, AU - Benson,Mitchell C, AU - McKiernan,James M, Y1 - 2009/10/26/ PY - 2009/10/30/entrez PY - 2009/10/30/pubmed PY - 2010/7/16/medline SP - 1646 EP - 9 JF - BJU international JO - BJU Int VL - 105 IS - 12 N2 - OBJECTIVES: To evaluate the effects of age at radical prostatectomy (RP) on recurrence-free survival (RFS) in patients with prostate cancer stratified by established preoperative risk factors (such as prostate-specific antigen (PSA) level, Gleason score, and tumour stage), as increasing age has been associated with more indolent behaviour in some cancers. PATIENTS AND METHODS: A retrospective analysis of men treated with RP from 1988 to 2008 was conducted. Patients were divided into two groups by age at the time of RP, and RFS rates were analysed using Kaplan-Meier survival curves. The subgroups were stratified by preoperative PSA level, biopsy Gleason score, and clinical stage; multivariate analyses with Cox proportional hazards models were used to identify independent predictors of recurrence. Recurrence was defined as a single PSA level of > or =0.2 ng/mL at least 28 days after RP. RESULTS: In all, 1984 patients met inclusion criteria and were divided into groups 1 (1325 men aged 40-64 years) and 2 (659 men aged > or =65 years). The 5-year RFS rates were 80.6% (confidence interval, CI 78.0-82.9%) and 75.6% (CI 71.5-79.1%) for groups 1 and 2, respectively. In the univariate model, advanced age was significantly associated with an increased overall risk of recurrence (hazard ratio, HR 1.30, P = 0.012). However, in multivariate analyses accounting for PSA level, Gleason score, and clinical stage, age was not an independent predictor of recurrence (HR 1.04, P = 0.76). CONCLUSION: Older patients who undergo RP appear to have an increased risk of recurrence. However, age is not an independent predictor of recurrence when accounting for PSA level, grade, and stage. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/19863523/The_relationship_between_age_at_time_of_surgery_and_risk_of_biochemical_failure_after_radical_prostatectomy_ L2 - https://doi.org/10.1111/j.1464-410X.2009.08977.x DB - PRIME DP - Unbound Medicine ER -