Radical Prostatectomy in Korean Men Aged 75-Years or Older: Safety and Efficacy in Comparison with Patients Aged 65–69 Years

• Published in: Journal of Korean medical science Vol. 31; no. 6; pp. 957 - 962
• Main Authors: Ryu, Jae Hyun, Kim, Yun Beom, Jung, Tae Young, Kim, Sun Il, Byun, Seok-Soo, Kwon, Dong Deuk, Kim, Duk Yoon, Oh, Tae Hee, Yoo, Tag Keun, Ko, Woo Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.06.2016; 대한의학회
• Subjects: Age Factors; Aged; Biopsy; Disease-Free Survival; Humans; Hypertension - epidemiology; Male; Middle Aged; Multivariate Analysis; Neoplasm Grading; Original; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Republic of Korea; Retrospective Studies; 의학일반; Prostatic Neoplasms; Prostatectomy; Treatment Outcome; Age Groups
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2016.31.6.957

Prostate cancer is the most common type of male cancer worldwide. Although radical prostatectomy (RP) is advised for prostate cancer in patients with a life expectancy of more than 10 years by various guidelines, most elderly men still do not undergo the procedure regardless of increasing life expectancy. This study aimed to determine whether RP is suitable for patients with prostate cancer aged 75 years or older. A retrospective study of patients who underwent RP at 6 institutions between 2005 and 2012 was conducted. Patients were divided into 2 groups at the time of surgery: 65-69 years (younger group) and 75 years or older (older group). We compared clinical characteristics, pathological results, complication rates, and recurrence-free survival between the two groups. Compared with the younger group, the older group had significantly higher preoperative serum prostate-specific antigen level, pre- and postoperative Eastern Cooperative Oncology Group (ECOG) performance status grade, hypertension prevalence, and Gleason score at biopsy and RP. However, except urinary incontinence, there were no statistically significant differences in the peri- and post-operative complications. After median follow-up periods of 36 months (younger group) and 40 months (older group), the biochemical recurrence-free survival rates were not significantly different (P = 0.581). Although the urinary incontinence rate was higher in the older group, RP was a suitable option for selected Korean men aged 75 years or older with limited complication rates and excellent outcomes similar to those for patients aged 65-69 years.