KEY TAKEAWAYS
- The study aimed to compare management patterns and cancer-specific mortality across age groups in men with prostate cancer.
- Increased curative treatment in older men with prostate cancer indicated reduced age bias and improved guideline adherence.
Previously, there have been reports of insufficient treatment for otherwise healthy men in their 70s with prostate cancer.
Frida E Lundberg and the team aimed to compare management patterns, cancer-specific mortality, and treatment outcomes across age groups in men with prostate cancer.
Utilizing data from a Swedish prostate cancer research database, researchers analyzed management patterns and cancer-specific mortality across age groups. They compared staging procedures, primary treatment modalities, and cancer-related mortality using regression models, adjusting for patient and tumor characteristics.
During the study period, the proportion of men receiving curative treatment increased significantly across various age groups: ages 70-74 (intermediate-risk: 45% to 72%; high-risk: 49% to 84%), 75-79 (intermediate-risk: 11% to 52%; high-risk: 12% to 70%), and 80-84 years (intermediate-risk: < 1% to 14%; high-risk: < 1% to 30%). Older age correlated with decreased likelihood of staging investigations and curative treatment, even after adjusting for tumor characteristics and comorbidity.
Men undergoing curative treatment or conservative management had lower crude risks of prostate cancer death compared to those receiving androgen deprivation treatment (ADT). In adjusted analyses, ADT was linked to higher prostate cancer mortality than curative treatment across all age groups and risk categories. Prostate cancer mortality was notably higher among men aged 70 and above who were managed conservatively.
The significant rise in curative treatment among older men with prostate cancer from 2008 to 2020 indicated a reduction in age bias and under-treatment. These results imply improved individualized decision-making and adherence to guidelines promoting more proactive management of older patients. Funding was provided by the Cancerfonden.
Source: https://pubmed.ncbi.nlm.nih.gov/38505996/
Lundberg F, Robinson D, Bratt O, et al. (2024) “Time trends in the use of curative treatment in men 70 years and older with nonmetastatic prostate cancer.” Acta Oncol. 2024 Mar 20;63:95-104. doi: 10.2340/1651-226X.2024.26189. PMID: 38505996.
