Are pathological and oncological outcomes of elderly men treated with radical prostatectomyworse than those of younger men? Matched-pair analysis between patients aged <70 and ≥70 years

Objective: To compare oncological outcomes of patients aged ≥70 years treated with radical prostatectomy with those of a clinically matched younger cohort. Methods: Data from 1268 patients undergoing radical prostatectomy between 2000 and 2009 were retrospectively reviewed. Patients were classified according to age (<70 or ≥70 years) at the time of prostatectomy. After matching pre-operative factors (i.e. prostate specific antigen, positive biopsy cores, Gleason score, clinical stage and D'Amico risk group), 333 patients were chosen from each group. Results: The percentage of pathological stage ≥T3 in those of age <70 and ≥70 years was 30.3 and 33.0%, respectively (P=0.51). The percentage of pathological Gleason score ≥6, 7 and ≥8 was not significantly different between the two age groups (P=0.08). The percentage of organ-confined disease in those of age <70 and ≥70 years was 69.4 and 67.0%, respectively (P=0.56). With a median follow-up of 50 months, 5-year prostate specific antigen recurrence-free survival in those of age <70 and ≥70 years was 83.4 and 80.1%, respectively (log rank, P=0.199). Five-year cancer-specific survival in those of age ,70 and ≥70 years was 100 and 99.4%, respectively (log rank, P=0.317). Five-year overall survival in those of age <70 and ≥70 years was 98.4 and 96.4%, respectively (log rank, P=0.228). Conclusions: Pathological and oncological outcomes in elderly patients (age ≥70 years) treated with radical prostatectomy were not significantly different from those of younger patients (age<70 years). This information will help refine the indications for definitive treatment for localized prostate cancer in elderly men.