Patients aged more than 70 had higher risk of locally advanced prostate cancers and biochemical recurrence in Korea

Objective To analyse the differences in the clinicopathological results between two groups of Korean patients aged younger or older than 70 years with clinically localized prostate cancer. METHODS A cohort of consecutive male patients who underwent radical prostatectomy was retrospectively analysed. In total, 995 patients (74.6%) were younger than 70 years, and 338 patients (25.4%) were 70 years or older. Biochemical recurrence (BCR) -free survival was evaluated in the patients, who were followed up for more than 24 months. The Kaplan-Meier method was used to calculate survival estimates for BCR-free survival. Multivariate Cox proportional hazard regression analysis was performed to predict non-organ-confined status and BCR. Results Mean preoperative prostate-specific antigen (PSA) levels and biopsy or pathological Gleason scores showed no differences between the two age groups. Older patients, aged more than 70 years, displayed significantly higher risk of locally advanced prostate cancer and BCR than younger patients. Subgroup analysis showed that the risk of the presence of locally advanced disease was significantly increased in patients of 70 years or older when we compared the proportion of locally advanced disease only in patients with PSA <4 ng/mL. Multivariate analysis showed that old age, high PSA and high Gleason score were significantly associated with non-organ confined status and BCR. ConclusionS Patients aged 70 years or older had a higher possibility of locally advanced cancer than younger patients. Radical eradication of clinically localized prostate cancer should be actively considered in well-selected healthy patients older than 70 years.