Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy

No AccessJournal of UrologyAdult urology1 Nov 2007Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy Ahmed Magheli, Soroush Rais-Bahrami, Elizabeth B. Humphreys, Hugh J. Peck, Bruce J. Trock, and Mark L. Gonzalgo Ahmed MagheliAhmed Magheli Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Urology, Marienhospital Herne, Herne, Germany More articles by this author , Soroush Rais-BahramiSoroush Rais-Bahrami Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Elizabeth B. HumphreysElizabeth B. Humphreys More articles by this author , Hugh J. PeckHugh J. Peck Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Bruce J. TrockBruce J. Trock Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland Financial interest and/or other relationship with Bristol Myers Squibb. More articles by this author , and Mark L. GonzalgoMark L. Gonzalgo Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.07.016AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. Materials and Methods: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. Results: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. Conclusions: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery. 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Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMandel P, Kriegmair M, Kamphake J, Chun F, Graefen M, Huland H and Tilki D (2016) Tumor Characteristics and Oncologic Outcome after Radical Prostatectomy in Men 75 Years Old or OlderJournal of Urology, VOL. 196, NO. 1, (89-94), Online publication date: 1-Jul-2016.Shikanov S, Desai V, Razmaria A, Zagaja G and Shalhav A (2010) Robotic Radical Prostatectomy for Elderly Patients: Probability of Achieving Continence and Potency 1 Year After SurgeryJournal of Urology, VOL. 183, NO. 5, (1803-1807), Online publication date: 1-May-2010.Sun L, Caire A, Robertson C, George D, Polascik T, Maloney K, Walther P, Stackhouse D, Lack B, Albala D and Moul J (2009) Men Older Than 70 Years Have Higher Risk Prostate Cancer and Poorer Survival in the Early and Late Prostate Specific Antigen ErasJournal of Urology, VOL. 182, NO. 5, (2242-2249), Online publication date: 1-Nov-2009.Shapiro E, Rais-Bahrami S, Morgenstern C, Napolitano B, Richstone L and Potters L (2009) Long-Term Outcomes in Younger Men Following Permanent Prostate BrachytherapyJournal of Urology, VOL. 181, NO. 4, (1665-1671), Online publication date: 1-Apr-2009. Volume 178Issue 5November 2007Page: 1933-1938 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsneoplasm recurrencelocalprostateage groupsprognosisprostatic neoplasmsAcknowledgmentsDr. H. Ballentine Carter provided discussion and critical review.MetricsAuthor Information Ahmed Magheli Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Urology, Marienhospital Herne, Herne, Germany More articles by this author Soroush Rais-Bahrami Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Elizabeth B. Humphreys More articles by this author Hugh J. Peck Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Bruce J. Trock Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland Financial interest and/or other relationship with Bristol Myers Squibb. More articles by this author Mark L. Gonzalgo Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...