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Year : 2022  |  Volume : 18  |  Issue : 2  |  Page : 391-398

The survival outcomes of very young and elderly patients with high-risk prostate cancer after radical treatments: A population-matched study

1 Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
2 The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China

Correspondence Address:
Qiang Dong
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_1862_21

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Objective: This study evaluated the survival outcomes of young (<50 years) and elderly patients (>80 years) with high-risk prostate cancer (PCa) postradical local treatments. Materials and Methods: We identified <50 and >80-year-old patients with high-risk PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database. The patients aged 65 and 66 years were also identified as the control group. The propensity-score matching method was adopted to compare the young and elderly patients with the control group. Kaplan–Meier analysis and Cox regression were conducted to evaluate the PCa-specific survival (PCSS) and overall survival. Results: A total of 17726 patients were identified, and 3355 were under 50 years old, whereas 4798 of them were >80 years old. The young patient group (<50 years) had similar PCSS with the control group (65–66 years) in both the overall cohort (hazard ratio [HR]: 0.88, 95% confidence interval [CI] [0.73–1.06], P = 0.132) and matched cohort (HR: 0.96, 95% CI [0.74–1.24], P = 0.527). Young patients with both high-risk and very high-risk PCa after radical prostatectomy (RP) treatment had apparent longer mean cancer-specific survival time than those after external-beam radiotherapy (EBRT) and/or brachytherapy (BT) treatment (high-risk group: 153.38 ± 0.82 months vs. 149.72 ± 3.03 months; very high-risk group: 148.3 ± 1.84 months vs. 139.33 ± 3.25 months). For the elderly patients (>80 years), the PCSS outcomes were significantly worse than the control group (65–66 years) in both overall cohort (HR: 2.69, 95% CI [2.31–3.13], P < 0.001) and matched cohort (HR: 1.61, 95% CI [1.34–1.94], P < 0.001). Patients receiving RP treatment had similar PCSS outcomes with those receiving EBRT and/or BT in the high-risk PCa group (139.45 ± 9.98 months vs. 139.41 ± 1.84 months), and better PCSS in very high-risk PCa group (132.73 ± 13.56 months vs. 128.82 ± 3.43 months). Conclusion: The PCSS outcomes of young PCa patients (<0 years) were identical to those of the control group (65–66 years). RP had similar or better PCSS benefits than EBRT and/or BT in both young (<50 years) and elderly patients (>80 years).

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