scholarly journals Carcinoma della prostata: prostatectomia radicale nei pazienti over 70

2013 ◽  
Vol 4 (2) ◽  
pp. 95-103
Author(s):  
Massimo Madonia ◽  
Paolo Soggia ◽  
Gianmarco Garau ◽  
Sebastiano Cimino ◽  
Giuseppe Morgia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Ageing Population ◽  
Industrialized Countries ◽  
Elderly Men ◽  
Slow Disease Progression ◽  
Effective Option ◽  
Significant Life ◽  
Low Incidence ◽  
Carcinoma Della Prostata

Prostate cancer is one of the most common male cancers in industrialized countries and it occurs mainly in men older than 50 years. In light of a rapidly ageing population it seems certain tha increasingly many septuagenarians with significant life-expectancy will present with prostate cancer to urologist. However currently there is a lack of consensus on prostate cancer and its treatment in the cohort of men ≥ 70 years of age. Although elderly men are often recommended a watchfull waiting option based on lower life expentancy and potentially slow disease progression, recent evidences indicate suggest a potential benefit of radical prostatectomy in selected older patients. The aim of this review is to illustrate the evidences demonstrating the efficacy and safety and of radical prostatectomy in patients over 70. Also, are presented the results of a small Italian study on patients aged ≥ 70 years with clinically localized prostate cancer undergoing radical prostatectomy. The results show that radical prostatectomy is a safe and effective option in elderly patients, with low incidence of complications and recovery of continence in about two-thirds of patients.

scholarly journals Carcinoma della prostata: prostatectomia radicale nei pazienti over 70

2013 ◽  
Vol 4 (2) ◽  
pp. 95
Author(s):  
Massimo Madonia ◽  
Paolo Soggia ◽  
Gianmarco Garau ◽  
Sebastiano Cimino ◽  
Giuseppe Morgia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Ageing Population ◽  
Industrialized Countries ◽  
Elderly Men ◽  
Slow Disease Progression ◽  
Effective Option ◽  
Significant Life ◽  
Low Incidence ◽  
Carcinoma Della Prostata

Prostate cancer is one of the most common male cancers in industrialized countries and it occurs mainly in men older than 50 years. In light of a rapidly ageing population it seems certain tha increasingly many septuagenarians with significant life-expectancy will present with prostate cancer to urologist. However currently there is a lack of consensus on prostate cancer and its treatment in the cohort of men ≥ 70 years of age. Although elderly men are often recommended a watchfull waiting option based on lower life expentancy and potentially slow disease progression, recent evidences indicate suggest a potential benefit of radical prostatectomy in selected older patients. The aim of this review is to illustrate the evidences demonstrating the efficacy and safety and of radical prostatectomy in patients over 70. Also, are presented the results of a small Italian study on patients aged ≥ 70 years with clinically localized prostate cancer undergoing radical prostatectomy. The results show that radical prostatectomy is a safe and effective option in elderly patients, with low incidence of complications and recovery of continence in about two-thirds of patients.

scholarly journals The Prognosis of Radical Prostatectomy, External Beam Radiotherapy plus Brachytherapy, and External Beam Radiotherapy Alone for Patients above 70 Years with Very High-Risk Prostate Cancer: A Population-Matched Study

2021 ◽  
pp. 1-9
Author(s):  
Pan Song ◽  
Mengxuan Shu ◽  
Luchen Yang ◽  
Xiaoyu Di ◽  
Peiwen Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Survival Curves ◽  
Elderly Men ◽  
High Risk Prostate Cancer ◽  
Matched Study ◽  
Very High

<b><i>Objective:</i></b> The aim of this study was to evaluate the survival outcomes of radical prostatectomy (RP), external beam radiotherapy plus brachytherapy (EBRT + BT), and EBRT alone among elderly men (aged 70 years and above) with very high-risk (VHR) prostate cancer (PCa). <b><i>Methods:</i></b> We identified elderly men diagnosed with VHR PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database. The propensity score-matching method was adopted to balance the covariates and generate new cohorts. ­Kaplan-Meier and Cox analyses were conducted to build up survival curves and evaluate the overall survival (OS) and PCa-specific survival (PCSS) outcomes. <b><i>Results:</i></b> A total of 9,818 patients were identified. Of them, 5,839 were in the EBRT group, 725 in the EBRT + BT group, and 3,254 in the RP group. The survival curves of the overall cohort showed that RP was associated with the best OS, followed by EBRT + BT and EBRT (<i>p</i> &#x3c; 0.001). As for the PCSS, RP shared similar outcomes with EBRT + BT (hazard ratio [HR]: 1.25 [0.93–1.69], <i>p</i> = 0.175). EBRT was associated with significantly worse PCSS than both RP (HR: 1.88, 95% confidence interval [95% CI] [1.64–2.15], <i>p</i> &#x3c; 0.001) and EBRT + BT (HR: 1.48, 95% CI [1.19–1.85], <i>p</i> = 0.002). In the matched cohorts, RP presented better OS (HR: 1.41, 95% CI [1.07–1.86], <i>p</i> = 0.041) and similar PCSS with EBRT + BT (HR: 1.50, 95% CI [0.91–2.47], <i>p</i> = 0.12). RP was associated with significantly better OS and PCSS outcomes than EBRT alone (OS HR: 1.58, 95% CI [1.59–2.12], <i>p</i> &#x3c; 0.001; PCSS HR: 2.08 [1.60–2.72], <i>p</i> &#x3c; 0.001). EBRT + BT also had significantly better OS and PCSS outcomes than EBRT alone (OS HR: 1.33, 95% CI [1.11–1.60], <i>p</i> &#x3c; 0.001; PCSS HR: 1.57 [1.13–2.19], <i>p</i> = 0.003). <b><i>Conclusions:</i></b> For patients above 70 years with VHR PCa, RP was associated with better OS and similar PCSS than EBRT + BT. Both RP and EBRT + BT have better OS and PCSS than EBRT alone.

Prostate cancer–specific mortality and competing causes of mortality among elderly men after local therapy for prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 103-103
Author(s):  
Maria Carmen Mir ◽  
Joseph C. Klink ◽  
Brandon Isariyawongse ◽  
Adam Stuart Kibel ◽  
Eric A. Klein ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Local Therapy ◽  
Elderly Men ◽  
Healthy Men ◽  
Specific Mortality ◽  
Causes Of Mortality ◽  
Cancer Specific Mortality ◽  
Competing Causes

103 Background: The benefit of definitive local therapy among elderly patients (> 65 years) with localized prostate cancer (PC) is uncertain, particularly for those with comorbid illness. Despite this uncertainty, the majority of these men currently receive local therapy. We analyzed the risk of prostate cancer-specific mortality (PCSM) relative to competing causes of mortality (CCM), stratified by disease severity and comorbidity, among contemporary men treated at two high-volume hospitals Methods: Between 1995-2005, 4237 consecutive men aged 65 years or older were managed by radical prostatectomy (N = 1634), external-beam radiotherapy (N = 1570), or brachytherapy (N = 1033) at Cleveland Clinic or Barnes-Jewish Hospital. Clinical information was obtained from prospective data bases. Comorbidity was assessed using ACE-27 and Charlson Comorbidity indices. PC risk was classified according to D’Amico criteria. Fine and Gray competing risk analysis was used to assess PCSM and CCM at 10 years. Results: Over a median follow-up of 72 months (IQR: 46-97), 88 and 748 PCSM and CCM events were observed. Among healthy men with low risk PC, 10 year PCSM was 2% and CCM was 19%. Among healthy men with high risk PC, PCSM was 11% and CCM was 27%. In the group with moderate-to-severe comorbidities, CCM was 49, 59%, and 58% and PCSM was 1%, 3%, and 21% among those with low-, intermediate- and high-risk PC, respectively. Among these unhealthy men, 26% were treated by radical prostatectomy, of whom 45% had low-risk PC and 16% had high-risk PC. Among healthy men, 41% were treated by radical prostatectomy, of whom 54% and 9% had low- and high-risk PC, respectively. Conclusions: The risk of PCSM vs. CCM for older men is low, particularly for those with moderate-to-severe comorbidity; 49-59% had died from CCM within 10 years. Current evidence suggests that local therapy for PC is associated with a 25% reduction in PCSM, at best. Thus, with active surveillance, it is unlikely that PCSM would exceed 5-7% in those with low- and intermediate-risk PC. These results should inform elderly men and physicians about the risk of PCSM and CCM when deciding upon treatment for localized PC.

Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer

2019 ◽  
Vol 38 (2) ◽  
pp. 351-360 ◽  
Author(s):  
Joanne Nyaboe Nyarangi-Dix ◽  
Georgi Tosev ◽  
Ivan Damgov ◽  
Philipp Reimold ◽  
Cem Aksoy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Elderly Men ◽  
Robot Assisted ◽  
Aggressive Prostate Cancer ◽  
Younger Men

Functional and perioperative outcomes in elderly men after robotic-assisted radical prostatectomy for prostate cancer

2020 ◽  
Vol 38 (11) ◽  
pp. 2791-2798 ◽  
Author(s):  
Samer L. Traboulsi ◽  
David-Dan Nguyen ◽  
Ahmed S. Zakaria ◽  
Kyle W. Law ◽  
Hanna Shahine ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Elderly Men ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy

232: Natural History of Treated Biochemical Recurrence after Radical Prostatectomy for Prostate Cancer

2007 ◽  
Vol 177 (4S) ◽  
pp. 77-78
Author(s):  
Christopher R. Porter ◽  
Jochen Walz ◽  
Andrea Gallina ◽  
Claudio Jeldres ◽  
Koichi Kodama ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Natural History ◽  
Biochemical Recurrence ◽  
History Of
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