Survival Differences in High-Risk Prostate Cancer by Age
Vol. 20 No. 04 (2023),
2 Mehr 2023
Purpose: Age is an established determining factor in survival in low-risk prostate cancer (PC), being this evidence
weaker in high-risk tumors. Our aim is to evaluate the survival of patients with high-risk PC treated with curative
intent and to identify differences across ages at diagnosis.
Methods: We did a retrospective analysis of patients with high-risk PC treated with surgery (RP) or radiotherapy
(RDT) excluding N+ patients. We divided patients by age groups: < 60, 60-70, and > 70 years. We performed a
comparative survival analysis. A multivariate analysis adjusted for clinically relevant variables and initial treatment
received was performed.
Results: Of a total of 2383 patients, 378 met the selection criteria with a median follow-up of 8.9 years: 38 (10.1%)
< 60 years, 175 (46.3%) between 60-70 years, and 165 (43.6%) >70 years. Initial treatment with surgery was
predominant in the younger group (RP:63.2%, RDT:36.8%), and with radiotherapy in the older group (RP:17%,
RDT:83%) (p = 0.001). In the survival analysis, significant differences were observed in overall survival, with
better results for the younger group. However, these results were reversed in biochemical recurrence-free survival,
with patients < 60 years presenting a higher rate of biochemical recurrence at 10 years. In the multivariate analysis,
age behaved as an independent risk variable only for overall survival, with a HR of 2.8 in the group >70 years
(95%CI: 1.22-6.5; p = 0.015).
Conclusion: In our series, age appeared to be an independent prognostic factor for overall survival, with no differences
in the rest of the survival rates.
- high-risk prostate cancer, age groups, survival differences.
How to Cite
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