Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy

Ahmed Magheli, Soroush Rais-Bahrami, Elizabeth B. Humphreys, Hugh J. Peck, Bruce J. Trock, Mark L Gonzalgo

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Purpose: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. Materials and Methods: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. Results: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. Conclusions: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery.

Original languageEnglish (US)
Pages (from-to)1933-1938
Number of pages6
JournalJournal of Urology
Volume178
Issue number5
DOIs
StatePublished - Nov 2007
Externally publishedYes

Fingerprint

Prostatectomy
Recurrence
Prostate-Specific Antigen
Proportional Hazards Models
Prostatic Neoplasms
Matched-Pair Analysis
Propensity Score
Neoplasm Grading
Seminal Vesicles
Kaplan-Meier Estimate
Survivors
Prostate
Multivariate Analysis
Lymph Nodes
Pathology
Biopsy

Keywords

  • age groups
  • local
  • neoplasm recurrence
  • prognosis
  • prostate
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy. / Magheli, Ahmed; Rais-Bahrami, Soroush; Humphreys, Elizabeth B.; Peck, Hugh J.; Trock, Bruce J.; Gonzalgo, Mark L.

In: Journal of Urology, Vol. 178, No. 5, 11.2007, p. 1933-1938.

Research output: Contribution to journalArticle

Magheli, A, Rais-Bahrami, S, Humphreys, EB, Peck, HJ, Trock, BJ & Gonzalgo, ML 2007, 'Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy', Journal of Urology, vol. 178, no. 5, pp. 1933-1938. https://doi.org/10.1016/j.juro.2007.07.016
Magheli, Ahmed ; Rais-Bahrami, Soroush ; Humphreys, Elizabeth B. ; Peck, Hugh J. ; Trock, Bruce J. ; Gonzalgo, Mark L. / Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy. In: Journal of Urology. 2007 ; Vol. 178, No. 5. pp. 1933-1938.
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abstract = "Purpose: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. Materials and Methods: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. Results: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. Conclusions: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery.",
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T1 - Impact of Patient Age on Biochemical Recurrence Rates Following Radical Prostatectomy

AU - Magheli, Ahmed

AU - Rais-Bahrami, Soroush

AU - Humphreys, Elizabeth B.

AU - Peck, Hugh J.

AU - Trock, Bruce J.

AU - Gonzalgo, Mark L

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N2 - Purpose: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. Materials and Methods: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. Results: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. Conclusions: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery.

AB - Purpose: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. Materials and Methods: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. Results: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. Conclusions: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery.

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