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The effect of age on cancer-specific mortality in patients with prostate cancer: a population-based study across all stages

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Abstract

Purpose

To test the effect of age on cancer-specific mortality (CSM) in most contemporary prostate cancer (PCa) patients of all stages and across all treatment modalities.

Methods

Within the Surveillance, Epidemiology, and End Results database (2004–2016), we identified 579,369 PCa patients. Cumulative incidence plots and multivariable competing-risks regression analyses (MCR) were used. Subgroup analyses were performed according to ethnicity (African-Americans), clinical stage (T1-2N0M0, T3-4N0M0, TanyN1M0, and TanyNanyM1), as well as treatment modalities.

Results

Patient distribution was as follows: 142,338 (24.6%) < 60 years; 113,064 (19.5%) 60–64 years; 127,158 (21.9%) 65–69 years; 94,782 (16.4%) 70–74 years; and 102,027 (17.6%) ≥ 75 years. Older patients harbored worse tumor characteristics and more frequently received no local treatment. Overall, 10-year CSM rates were 4.8, 5.3, 5.9, 7.6, and 14.6%, respectively, in patients aged < 60, 60–64, 65–69, 70–74 ,and ≥ 75 years (p < 0.001). In MCR focusing on the overall cohort and T1-2N0M0 patients, older age independently predicted higher CSM, but not in T3-4N0-1M0-1 patients.

Conclusions

Older age was associated with higher grade and stage and independently predicted higher CSM in T1-2N0M0 patients, but not in higher stages. Differences in diagnostics and therapeutics seem to affect elderly patients within T1-2N0M0 PCa and should be avoided if possible.

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Funding

There was no external financial support for this study.

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Authors and Affiliations

  1. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Sophie Knipper, Derya Tilki & Markus Graefen

  2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada

    Sophie Knipper, Angela Pecoraro, Carlotta Palumbo, Giuseppe Rosiello, Stefano Luzzago, Marina Deuker, Zhe Tian, Fred Saad & Pierre I. Karakiewicz

  3. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy

    Angela Pecoraro

  4. Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy

    Carlotta Palumbo

  5. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Giuseppe Rosiello

  6. European Institute of Oncology, Milan, Italy

    Stefano Luzzago

  7. Department of Urology, University Hospital Frankfurt, Frankfurt, Germany

    Marina Deuker

  8. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Shahrokh F. Shariat

  9. Institute of Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Shahrokh F. Shariat

  10. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Derya Tilki

Authors
  1. Sophie Knipper
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  2. Angela Pecoraro
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  3. Carlotta Palumbo
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  4. Giuseppe Rosiello
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  5. Stefano Luzzago
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  6. Marina Deuker
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  7. Zhe Tian
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  8. Shahrokh F. Shariat
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  9. Fred Saad
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  10. Derya Tilki
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  11. Markus Graefen
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  12. Pierre I. Karakiewicz
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Corresponding author

Correspondence to Sophie Knipper.

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Knipper, S., Pecoraro, A., Palumbo, C. et al. The effect of age on cancer-specific mortality in patients with prostate cancer: a population-based study across all stages. Cancer Causes Control 31, 283–290 (2020). https://doi.org/10.1007/s10552-020-01273-5

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  • DOI: https://doi.org/10.1007/s10552-020-01273-5

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