Findings support decisions based on disease risk and life expectancy rather than chronologic age

Tuesday, December 7, 2010 (Last Updated: 12/08/2010)

TUESDAY, Dec. 7 (HealthDay News) -- Potentially curative local therapy is underused among older men with high-risk prostate cancer, which may partially explain age-related differences in cancer-specific survival, according to research published online Dec. 6 in the Journal of Clinical Oncology.

Seth K. Bechis, of the University of California in San Francisco, and colleagues conducted a study of 13,805 men with biopsy-proven prostate cancer included in a U.S. disease registry. The purpose of the study was to determine the impact of age at diagnosis on disease risk and survival.

The researchers found that 26 percent of men age 75 or older were diagnosed with high-risk disease and older men were more likely to be treated with androgen deprivation monotherapy. When controlled for treatment modality, and for the combination of treatment modality and risk level, age was not an independent risk factor for prostate cancer-specific survival. When controlled for age and risk, older men with high-risk tumors had a 46 percent mortality reduction when treated with local therapy rather than by conservative therapy. The authors write that underuse of potentially curative local therapy in older men with high-risk disease may partly explain the age-related differences in cancer-specific survival.

"When controlling for treatment modality alone, or treatment modality and cancer risk category, age is not an independent predictor of prostate cancer-specific survival," the authors write. "These findings highlight the importance of making treatment decisions guided by disease risk and life expectancy rather than chronologic age."

Two of the authors disclosed receiving relevant honoraria from pharmaceutical companies.

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Specialties Hematology & Oncology

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