Age 70 +/- 5 Years and Cancer-Specific Outcomes After Treatment of Localized Prostate Cancer: A Systematic Review

Area of Science:

• Oncology
• Urology
• Geriatric Medicine

Background:

• Existing research presents conflicting findings on the prognostic significance of older age in prostate cancer treatment.
• Some studies suggest older age is favorable with external beam radiation therapy (EBRT), while others indicate it's unfavorable with radical prostatectomy (RP).

Approach:

• A systematic review was conducted using PubMed (1999-2023) to evaluate age's effect on cancer-specific outcomes after definitive local treatment (RP or EBRT).
• The review assessed interactions between age (cutoff 70 ± 5 years) and treatment type concerning adverse cancer-specific outcomes.
• Forty-five studies were included: 30 on RP and 15 on EBRT.

Key Points:

• In radical prostatectomy (RP) studies, 50% suggested older age was associated with worse outcomes; none indicated a favorable prognostic role.
• In external beam radiation therapy (EBRT) studies, 53% suggested older age was associated with better outcomes, with an additional 21% trending favorably.
• No EBRT studies indicated older age was an adverse prognostic factor.

Conclusions:

• Older age (≥70 years) may be an adverse prognostic factor for men undergoing radical prostatectomy (RP).
• Conversely, older age appears to be a favorable prognostic factor for men treated with external beam radiation therapy (EBRT).
• Further research is required to validate these age-treatment interaction findings.