Older age at the time of a prostate cancer (PCa) diagnosis is associated with a higher risk of cancer-specific mortality (CSM), even after adjusting for the risk of death from other causes, researchers reported at the Canadian Urological Association annual meeting in St. John’s, Newfoundland.
Vincent Trudeau, MD, of the University of Montreal Health Center, and collaborators studied 205,551 men with clinically localized PCa who underwent radical prostatectomy from 1988 to 2009. The researchers stratified subjects by age group: age 50 or younger; 51-60; 61-70; and 71 and older.
Compared with men aged 50 and younger (the reference group), those aged 61-70 and 71 and older had a significant 28% and 49% increased risk of CSM, respectively, in a multivariable competing-risks regression model. CSM risk did not differ significantly among men aged 51-60.
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Among men with more aggressive disease, such as those with Gleason scores of 8-10 and pT3b tumors, age at diagnosis did not independently predict CSM.
“Those findings could fuel further research on the biological characteristics of PCa in older individuals,” Dr. Trudeau said.
Moreover, the study showed that the risk of dying of PCa among older patients with high grade/stage disease was significant. Specifically, the 15-year CSM rates of patients with Gleason 8-10 and pT3b disease were approximately 13% and 20%, respectively. “Those findings highlight the need for improved therapies for aggressive PCa, whatever the age of the patient at diagnosis,” he said.