Munich, Germany (UroToday.com) Despite contrary to several guideline recommendations, primary ADT (PADT) is commonly used in elderly men with localized prostate cancer. The group evaluated the survival patterns of men 80 to 90 years of age with localized prostate cancer treated by PADT.
SEER database was used to identify 14,785 octo-and nonagenarian men with localized prostate cancer treated with PADT from 1991-2009. Overall Mortality, Cancer Specific Mortality, and Other Cause Mortality rates were obtained stratified by age (80-84 vs 85-89 vs ≥90) and CCI. Multivariable analysis was performed to determine the combined effect of age and CCI on survival after adjusting for grade of disease, clinical stage, race, socio-economic status and year of diagnosis.
80% of the deaths were due to non-cancer causes while only 20% was due to prostate cancer. The 10-year OS rate in overall population was 15.4%. The 10-year OS rate was 24.6% in younger and healthier patients (patients aged 80-84 and CCI=0) vs. 8.8% in older men with comorbidities (patients aged ≥85 and CCI≥1). The 10-year Other Cause Mortality rate was 57.1% in younger patients with no comorbidities vs. 75.7% in older me with comorbidities. In multivariable analysis, advanced age of diagnosis (HR 1.09), CCI score 1 (HR 1.09) and CCI Score ≥2 (HR 1.51) were independent predictors of higher overall mortality.
The group concludes that men in 80’s and 90’s with localized prostate cancer who are treated with PADT have poor life expectancy at 10 years follow-up. Most die of other causes rather than by prostrate cancer, which questions the need for PADT in these patients.
Presented By:
Dell’Oglio P.1, Bishr M.1, Boehm K.2, Trudeau V.1, Larcher A.3, Tian Z.4, Saad F.5, Capitanio U.3, Briganti A.3, Graefen M.2, Montorsi F.3, Karakiewicz P.1
Reported By:
Mohammed Haseebuddin, MD, at the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany
Fox Chase Cancer Center