Radical prostatectomy in patients over 70 years of age: survival analysis

The possible benefits of radical surgical treatment for prostate cancer in elderly patients are controversial. The data of 1367 patients who had undergone radical prostatectomy (RPE) in the Clinics of Urology, S.P. Kirov Military Medical Academy, in 1997 to 2003 and in the Clinic of Urology, Russian Medical Academy of Postgraduate Education, in 2001 to 2010 were retrospectively analyzed. In the patient age group of >= 70 years, the five-and ten-year relapse-free survival rates were 76.4 and 70 %, respectively. In that of < 70 years, those were 79.1 and 75.4 % (p = 0.76). The five-and ten-year overall survival rates were 88.5 and 75.4 % in the patients aged = 70 years and 95.2 and 87.7 % in those aged with >= 70 years (p = 0.02). The ten-year cancer-specific survival rate was 99.1 and 95.6 % in the groups of >= 70 and < 70 years, respectively. The cause of death was cardiovascular diseases in more than half of the patients over 70 years of age (52.9 % of all deaths; 7.4 % of the entire cohort). In the patients aged above 70 years, indications for surgical treatment should be individually determined via aggregate assessment of cancer potential, surgical and anesthetic risks, and life expectancy.