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AUA 2011 - Age and aggressive prostate cancer in patients with low risk characteristics. Implications for conservative management - Session Highlights

WASHINGTON, DC USA (UroToday.com) - Dr. Andrea Gallina reported that in low risk prostate cancer (CaP) patients subjected to radical prostatectomy (RP), higher rates of both pathological high grade and non-OC (NOC) disease should be expected in older men.

The study evaluated the impact of age on the rate of high grade and NOC disease at RP in patients with low risk CaP. The biopsy and RP data of 1,637 pts subjected to RP for low risk prostate cancer between 1996 and 2009 at a single tertiary referral center was reviewed. All patients underwent at least 10-core biopsies at diagnosis. High grade CaP at RP was defined as a pathological Gleason ឋ. The rates of high grade as well as of NOC (pT3) disease at RP were analyzed. Logistic regression analyses targeted the rates of high grade and NOC disease at RP according to patient age at surgery coded in tertiles (<60, 60-70 and >71). All analyses were adjusted for pre-op clinical characteristics (PSA at diagnosis, prostate volume, number of cores taken, number of positive cores) and for year of surgery.

Mean patient age was 64 yrs, mean PSA was 5.8ng/ml, mean number of cores taken was 16, and mean number of positive cores was 5. Overall, high grade CaP at RP was observed in 645 patients (39.4%), while 177 men (10.8%) had NOC disease at RP. In univariable logistic regression analyses, patient age was significantly associated with high grade as well as with the rate of NOC disease at RP (p=0.002 and p=0.001, respectively). The rate of high-grade CaP and NOC disease was 36.1, 37.8, 47.8% and 7.6, 10.4, 16.7% in patients with <60, 60-70 and >71 years, respectively (all p<0.001). At multivariable logistic regression analyses, after adjusting for PSA, prostate volume, number of cores taken, number of positive cores and year of surgery, age at surgery maintained a significant association with both high grade and NOC disease at RP (p=0.001 and p=0.04, respectively). Patients older than 70 years had a 2.6 and 3.1 fold higher risk of high grade and NOC disease, respectively, as compared to patients aged less than 60 years.

 

Presented by Andrea Gallina, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA


Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.


 

The opinions expressed in this article are those of the UroToday.com Contributing Editor and do not necessarily reflect the viewpoints of the American Urological Association.

 

 



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