摘要 Objective: To assess the clinicopathological features and overall survival between two groups of Chinese patients older or younger than 70 years after retropubic radical prostatectomy. Methods: From January 2001 to February 2010, 390 patients receive dretropubic radical prostatectomy. After excluding 89 patients with adjuvant or neoadjuvant hormonal therapy or radiotherapy, a total of 301 patients were included in this study. We arbitrarily divided these patients into younger age group (<70 years, 140 cases, 46.5%) and older age group (70 years, 161 cases, 53.5%). The differences in serum prostate specific antigen (PSA), Gleason score, clinical tumor stage, and biochemical-free survival were analyzed between the two groups. Results: There were not significant differences between the two groups in high Gleason score rate and clinical tumor stage. However, older patients had significantly lower biochemical recurrence rate than those of younger patients, and had significantly higher PSA levels. Multivariate analysis showed that older age, PSA level and clinical tumor stage were significantly associated with biochemical recurrence free survival. Conclusion: In Chinese men, older age (70 years) is associated with better outcome. If the physical condition permits, older age alone should not exclude patients from radical prostatectomy.
Abstract: Objective: To assess the clinicopathological features and overall survival between two groups of Chinese patients older or younger than 70 years after retropubic radical prostatectomy. Methods: From January 2001 to February 2010, 390 patients receive dretropubic radical prostatectomy. After excluding 89 patients with adjuvant or neoadjuvant hormonal therapy or radiotherapy, a total of 301 patients were included in this study. We arbitrarily divided these patients into younger age group (<70 years, 140 cases, 46.5%) and older age group (70 years, 161 cases, 53.5%). The differences in serum prostate specific antigen (PSA), Gleason score, clinical tumor stage, and biochemical-free survival were analyzed between the two groups. Results: There were not significant differences between the two groups in high Gleason score rate and clinical tumor stage. However, older patients had significantly lower biochemical recurrence rate than those of younger patients, and had significantly higher PSA levels. Multivariate analysis showed that older age, PSA level and clinical tumor stage were significantly associated with biochemical recurrence free survival. Conclusion: In Chinese men, older age (70 years) is associated with better outcome. If the physical condition permits, older age alone should not exclude patients from radical prostatectomy.
Haifeng Wang, Xu Gao, Ziyu Fang, Xin Lu, Yan Wang, Chunfei Ma, Zhenkai Shi, Bo Yang, Shancheng Ren, Chuanliang Xu, Yinghao Sun. The older the better: The characteristic of localized prostate cancer in Chinese men[J]. Asian Journal of Urology, 2015, 2(3): 129-132.
Haifeng Wang, Xu Gao, Ziyu Fang, Xin Lu, Yan Wang, Chunfei Ma, Zhenkai Shi, Bo Yang, Shancheng Ren, Chuanliang Xu, Yinghao Sun. The older the better: The characteristic of localized prostate cancer in Chinese men. Asian Journal of Urology, 2015, 2(3): 129-132.
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:11-10.
[2]
Yu H, Harris RE, Gao YT, Gao R, Wynder EL. Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States. Int J Epidemiol 1991;20:76-61.
[3]
Ren S, Peng Z, Mao JH, Yu Y, Yin C, Gao X, et al. RNA-seq analysis of prostate cancer in the Chinese population identifies recurrent gene fusions, cancer-associated long noncoding RNAs and aberrant alternative splicings. Cell Res 2012; 22:806-61.
[4]
Fowler Jr FJ, McNaughton CM, Albertsen PC, Zietman A, Elliott DB, Barry MJ. Comparison of recommendations by urologists and radiation oncologists for treatment of clinically localized prostate cancer. JAMA 2000;283:3217-72.
[5]
Centers for Disease Control and Prevention (CDC). Trends in agingeUnited States and worldwide. MMWR Morb Mortal Wkly Rep 2003;52:101-1.106.
[6]
Minino AM, Smith BL. Deaths:preliminary data for 2000. Natl Vital Stat Rep 2001;49:1-10.
[7]
Richstone L, Bianco FJ, Shah HH, Kattan MW, Eastham JA, Scardino PT, et al. Radical prostatectomy in men aged > or =70 years:effect of age on upgrading, upstaging, and the accuracy of a preoperative nomogram. BJU Int 2008;101:541-1.
[8]
Siddiqui SA, Sengupta S, Slezak JM, Bergstralh EJ, Leibovich BC, Myers RP, et al. Impact of patient age at treatment on outcome following radical retropubic prostatectomy for prostate cancer. J Urol 2006;175:952-2.
[9]
Greco KA, Meeks JJ, Wu S, Nadler RB. Robot-assisted radical prostatectomy in men aged > or =70 years. BJU Int 2009;104:1492-2.
[10]
Pfitzenmaier J, Pahernik S, Buse S, Haferkamp A, Djakovic N, Hohenfellner M. Survival in prostate cancer patients > or =70 years after radical prostatectomy and comparison to younger patients. World J Urol 2009;27:637-72.
[11]
Brassell SA, Rice KR, Parker PM, Chen Y, Farrell JS, Cullen J, et al. Prostate cancer in men 70 years old or older, indolent or aggressive:clinicopathological analysis and outcomes. J Urol 2011;185:132-2.
[12]
Xu DD, Sun SD, Wang F, Sun L, Stackhouse D, Polascik T, et al. Effect of age and pathologic Gleason score on PSA recurrence:analysis of 2911 patients undergoing radical prostatectomy. Urology 2009;74:654-4.
[13]
Kim JK, Cho SY, Jeong CW, Lee SB, Ku JH, Hong SK, et al. Patients aged more than 70 had higher risk of locally advanced prostate cancers and biochemical recurrence in Korea. BJU Int 2012;110:505-5.
[14]
Masuda H, Fukushima H, Kawakami S, Numao N, Fujii Y, Saito K, et al. Impact of advanced age on biochemical recurrence after radical prostatectomy in Japanese men according to pathological stage. Jpn J Clin Oncol 2013;43:410-0.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
