Open AccessThe impact of age on prostate cancer progression and quality of life in active surveillance patients
Author(s) -
Merrick Gregory S.,
Rohmann Gabe,
Galbreath Robert,
Scholl Whitney,
Fiano Ryan,
Bennett Abbey,
Butler Wayne M.,
Adamovich Edward
Publication year - 2021
Publication title -
bjui compass
Language(s) - English
Resource type - Journals
ISSN - 2688-4526
DOI - 10.1002/bco2.52
Subject(s) - medicine , prostate cancer , quality of life (healthcare) , sexual function , biopsy , prostate , urinary system , cancer , surgery , urology , nursing
Objectives To evaluate the impact of age on overall survival (OS), freedom from distant metastasis (FDM), rates of therapeutic intervention (TI), and quality of life (QOL) in active surveillance (AS) prostate cancer patients. Materials and methods Three hundred and five consecutive, prospectively evaluated AS patients who underwent a staging transperineal template‐guided mapping biopsy (TTMB) prior to enrollment on AS were evaluated and stratified by age. Evaluated outcomes included OS, FDM, TI, and QOL to include urinary, bowel, sexual function, and depression. Post void residual (PVR) urine measurements were also followed. Repeat biopsy was based on PSA kinetics, abnormal digital rectal examination or patient preference. Results Of the 305 patients, 290 (95.1%) were Gleason 3 + 3 and 15 patients (4.9%) were Gleason 3 + 4. The median follow‐up was 5.5 years (range 1‐14 years). At 10 years, TI was 0%, 1.0%, and 11.4% for patients ≤59, 60‐69, and ≥70 years of age ( P < .001). No patient has developed distant metastasis. The median time to TI was 4.71 years. No statistical differences in urinary function, bowel function, or depression were noted. Potency preservation was dependent on patient age. Conclusion Within the confines of the follow‐up of our series, younger patients were less likely to proceed to therapeutic intervention. In addition, patient age did not adversely impact QOL outcomes.