Document Detail


Men older than 70 years have higher risk prostate cancer and poorer survival in the early and late prostate specific antigen eras.
MedLine Citation:
PMID:  19758616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We clarified whether men older than 70 years have a higher risk of prostate cancer and poorer survival in the early and late prostate specific antigen eras. MATERIALS AND METHODS: A cohort of 4,561 men who underwent radical prostatectomy were stratified into 3 age groups (younger than 60, 60 to 70 and older than 70 years), and early and late prostate specific antigen eras based on the year of surgery (before 2000 and 2000 or later). Race, body mass index, prostate specific antigen, prostate weight, tumor volume, pathological Gleason sum, pathological tumor stage, extracapsular extension, seminal vesicle invasion and surgical margin status were submitted for univariate and multivariable analyses against the previously mentioned groups. Survivals (prostate specific antigen recurrence, distant metastasis and disease specific death) were compared among the 3 age groups using univariate and multivariable methods. RESULTS: Compared with younger age groups (younger than 60, 60 to 70 years) men older than 70 years had a higher proportion of pathological tumor stage 3/4 (33.0 vs 44.3 vs 52.1%, p <0.001), pathological Gleason sum greater than 7 (9.5% vs 13.4% vs 17.2%, p <0.001) and larger tumor volume (3.7 vs 4.7 vs 5.2 cc, p <0.001). Pathological Gleason sum in men older than 70 years did not differ between the early and late prostate specific antigen eras (p = 0.071). Men older than 70 years had a higher risk of prostate specific antigen recurrence, distant metastasis and disease specific death on univariate (p <0.05) but not multivariable analysis. CONCLUSIONS: Men older than 70 years had higher risk disease and poorer survival in the early and late prostate specific antigen eras. Pathological Gleason sums did not change between the 2 eras. Patient age was an important variable in prostate specific antigen screening, biopsy, treatment and prognosis.
Authors:
Leon Sun; Arthur A Caire; Cary N Robertson; Daniel J George; Thomas J Polascik; Kelly E Maloney; Philip J Walther; Danielle A Stackhouse; Benjamin D Lack; David M Albala; Judd W Moul
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-16
Journal Detail:
Title:  The Journal of urology     Volume:  182     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2009-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2242-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Urology, Department of Surgery, Duke University Medical Center, Duke Prostate Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Age Factors
Aged
Humans
Male
Middle Aged
Prostate-Specific Antigen / blood*
Prostatic Neoplasms / blood*,  epidemiology*,  mortality
Risk Factors
Survival Rate
Chemical
Reg. No./Substance:
EC 3.4.21.77/Prostate-Specific Antigen
Comments/Corrections
Comment In:
J Urol. 2009 Nov;182(5):2248; discussion 2248-9   [PMID:  19758637 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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