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Does age matter in the selection of treatment for men with early‐stage prostate cancer?
Author(s) -
Konski Andre,
Eisenberg Debra,
Horwitz Eric,
Hanlon Alexandra,
Pollack Alan,
Hanks Gerald
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21923
Subject(s) - medicine , prostate cancer , prostate , radiation therapy , stage (stratigraphy) , androgen deprivation therapy , external beam radiation , cancer , urology , log rank test , survival analysis , paleontology , biology
Abstract BACKGROUND The specific aim of the current study was to compare freedom from biochemical failure, distant metastases‐free survival, and overall survival in men age ≤55 years, men ages 60 to 69 years, and men age ≥70 years presenting with localized prostate cancer. METHODS A matched pair analysis compared patients age ≤55 years (Group 1) who were treated with 3‐dimension conformal radiation without androgen deprivation to men age ≥60 years and <70 years (Group 2), and men age ≥70 years (Group 3) who were treated at the Fox Chase Cancer Center between November 1989 and October 2001. The groups were matched for disease stage (T1/T2b vs. T2C/T3), Gleason grade (2‐6 vs. 7‐10), radiation dose (<70 Gray [Gy] vs. ≥70–76 Gy vs. ≥76 Gy), and pretreatment prostate‐specific antigen (PSA) level. Estimates of outcome were accomplished using Kaplan‐Meier methodology and compared by age group using the log‐rank test. RESULTS Eighty‐four men were identified according to the selection criteria. No statistically significant difference was found in the 5‐year overall survival rates for Group 1, Group 2, and Group 3 (94%, 95%, and 87%, respectively) or the 5‐year rate of freedom from biochemical failure in Group 1, Group 2, and Group 3 (82%, 76%, and 70%, respectively), or freedom from distant metastases (96%, 97%, and 98%, respectively). CONCLUSIONS Men age ≤55 years who present with localized prostate cancer do not appear to have a worse prognosis. External beam radiation therapy appears to be a viable treatment alternative and should be offered to men age ≤55 years who present with organ‐confined prostate cancer. Cancer 2006. © 2006 American Cancer Society.