Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology

被引:169
作者
Droz, Jean-Pierre [1 ,2 ]
Balducci, Lodovico [4 ]
Bolla, Michel [3 ]
Emberton, Mark [8 ]
Fitzpatrick, John M. [9 ,10 ]
Joniau, Steven [11 ]
Kattan, Michael W. [5 ]
Monfardini, Silvio [12 ]
Moul, Judd W. [6 ]
Naeim, Arash [7 ]
van Poppel, Hendrik [11 ]
Saad, Fred [14 ]
Sternberg, Cora N. [13 ]
机构
[1] Ctr Leon Berard, Dept Med Oncol, F-69008 Lyon, France
[2] Univ Lyon 1, Dept Med Oncol, F-69365 Lyon, France
[3] Albert Michallon Hosp, Dept Radiat Therapy, Grenoble, France
[4] Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL 33612 USA
[5] Case Western Reserve Univ, Dept Quantitat Hlth Sci, Cleveland Clin, Cleveland Clin Lerner Coll Med, Cleveland, OH 44106 USA
[6] Duke Univ, Med Ctr, Div Urol Surg, Durham, NC USA
[7] Univ Calif Los Angeles, David Geffen Sch Med, Div Hematol Oncol & Geriatr, Los Angeles, CA 90095 USA
[8] UCL, Inst Urol & Nephrol, London WC1E 6BT, England
[9] Mater Misericordiae Univ Hosp, Dublin, Ireland
[10] Univ Coll Dublin, Dublin 2, Ireland
[11] Univ Hosp Leuven, Dept Urol, Leuven, Belgium
[12] Ist Palazzolo, Ist Oncol, Geriatr Oncol Program, Milan, Italy
[13] San Camillo Forlanini Hosp, Dept Med Oncol, Rome, Italy
[14] Univ Montreal, Notre Dame Hosp, Ctr Hosp Univ Montreal, Urooncol Clin, Montreal, PQ H3C 3J7, Canada
关键词
elderly; guidelines; localized disease; metastatic; prostate cancer; MITOXANTRONE PLUS PREDNISONE; ANDROGEN DEPRIVATION THERAPY; RADICAL PROSTATECTOMY; ELDERLY-PATIENTS; DOCETAXEL; AGE; RADIATION; SURVIVAL; RISK; SUPPRESSION;
D O I
10.1111/j.1464-410X.2010.09334.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Prostate cancer is the most prevalent cancer in men and predominantly affects older men (aged >= 70 years). The median age at diagnosis is 68 years; overall, two-thirds of prostate cancer-related deaths occur in men aged >= 75 years. With the exponential ageing of the population and the increasing life-expectancy in developed countries, the burden of prostate cancer is expected to increase dramatically in the future. To date, no specific guidelines on the management of prostate cancer in older men have been published. The International Society of Geriatric Oncology (SIOG) conducted a systematic bibliographic search based on screening, diagnostic procedures and treatment options for localized and advanced prostate cancer, to develop a proposal for recommendations that should provide the highest standard of care for older men with prostate cancer. The consensus of the SIOG Prostate Cancer Task Force is that older men with prostate cancer should be managed according to their individual health status, which is mainly driven by the severity of associated comorbid conditions, and not according to chronological age. Existing international recommendations (European Association of Urology, National Comprehensive Cancer Network, and American Urological Association) are the backbone for localized and advanced prostate cancer treatment, but need to be adapted to patient health status. Based on a rapid and simple evaluation, patients can be classified into four different groups: 1, 'Healthy' patients (controlled comorbidity, fully independent in daily living activities, no malnutrition) should receive the same treatment as younger patients; 2, 'Vulnerable' patients (reversible impairment) should receive standard treatment after medical intervention; 3, 'Frail' patients (irreversible impairment) should receive adapted treatment; 4, Patients who are 'too sick' with 'terminal illness' should receive only symptomatic palliative treatment.
引用
收藏
页码:462 / 469
页数:8
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