Radical prostatectomy in older men: Survival outcomes in septuagenarians and octogenarians

BJU International

Volumn 106, Issue 6, 2010, Pages 791-795

  Pierorazio, Phillip M ^a   Humphreys, Elizabeth ^a   Walsh, Patrick C ^a   Partin, Alan W ^a   Han, Misop ^a  

^a DEPARTMENT OF PATHOLOGY   (United States)

Author keywords

elderly; outcomes; prostate cancer; radical prostatectomy

Indexed keywords

PROSTATE SPECIFIC ANTIGEN;

ACCIDENT; AGED; ARTICLE; CANCER MORTALITY; CANCER SURVIVAL; CARDIOVASCULAR DISEASE; CAUSE SPECIFIC SURVIVAL; CONTROLLED STUDY; DATA BASE; DISEASE SEVERITY; FOLLOW UP; GERIATRIC PATIENT; GLEASON SCORE; HUMAN; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; NEUROLOGIC DISEASE; OVERALL SURVIVAL; PNEUMONIA; POSTOPERATIVE COMPLICATION; POSTOPERATIVE HEMORRHAGE; PREOPERATIVE EVALUATION; PRIORITY JOURNAL; PROSTATE BIOPSY; PROSTATE CANCER; PROSTATECTOMY; RETROSPECTIVE STUDY; RISK ASSESSMENT; THROMBOPHLEBITIS; TREATMENT OUTCOME; TUMOR BIOPSY; AGE; METABOLISM; MORTALITY; PROSTATIC NEOPLASMS; SURVIVAL; VERY ELDERLY;

AGE FACTORS; AGED; AGED, 80 AND OVER; HUMANS; MALE; PROSTATE-SPECIFIC ANTIGEN; PROSTATECTOMY; PROSTATIC NEOPLASMS; SURVIVAL ANALYSIS; TREATMENT OUTCOME;

EID: 77956221919     PISSN: 14644096     EISSN: 1464410X     Source Type: Journal    
DOI: 10.1111/j.1464-410X.2010.09239.x     Document Type: Article

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17. Bill-Axelson A, Holmberg L, Filen F et al. Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian prostate cancer group-4 randomized trial. J Natl Cancer Inst 2008 100 : 1144 1154 The issue with RP in older men is not whether they can tolerate the surgery without excessive perioperative morbidity, but whether they derive any survival benefit from the operation. Undoubtedly, there are some men aged >70 years who have a clinically significant but apparently localized cancer. Those with high-grade tumours might be well served by surgical intervention. However, most of the patients in this series had stage T1C, Gleason grade 6 or 7 cancers. Functional outcomes are not reported but erectile dysfunction and, to some degree incontinence, are more common in older men who undergo RP. Most men aged >70 years whose cancers would be categorized as good risk or possibly intermediate risk, do not derive a survival benefit from surgery and should not undergo RP, even though they can survive the operation with relatively minimal perioperative morbidity. For those with high-grade but apparently localized tumours, surgery might have an important role. Joseph A. Smith, Jr, Professor and Chairman, Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA