Impact of age on treatment response in men with prostate cancer treated with radiotherapy
© 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company..
Objective: To analyse the effect of age at diagnosis on clinical outcomes of localized prostate cancer (PCa) treated with radiation therapy.
Subjects and methods: We identified 12 784 patients with intermediate- or high-risk localized PCa treated with radiation therapy (RT) and neoadjuvant androgen deprivation therapy (ADT) between 2000 and 2015 from nationwide Veterans Affairs data. Patients were grouped into three age categories (≤59, 60-69, and ≥70 years old). Outcomes included immediate PSA response (3-month post-RT PSA and 2-year PSA nadir, grouped into <0.10 ng/ml, 0.10-0.49 ng/ml, and ≥0.50 ng/ml), biochemical recurrence, and PCa-specific mortality. Multivariable regression models included ordinal logistic regression for short-term PSA outcomes, Cox regression for biochemical recurrence, and Fine-Gray competing risks regression for PCa-specific mortality.
Results: A total of 2136 patients (17%) were ≤59 years old at diagnosis, 6107 (48%) were 60-69 years old, and 4541 (36%) were ≥70 years old. Median follow-up was 6.3 years. Younger age was associated with greater odds of higher 3-month PSA group (≤59 vs. ≥70: adjusted odds ratio [aOR] 1.90, 95% CI 1.64-2.20; p < 0.001) and higher 2-year PSA nadir group (≤59 vs. ≥70: aOR 1.89, 95% CI 1.62-2.19, p < 0.001). Younger age was associated with greater risk of biochemical recurrence (≤59 vs. ≥70: adjusted hazard ratio 1.45, 95% CI 1.26-1.67, p < 0.001) but not PCa-specific mortality (p = 0.16).
Conclusion: In a large nationwide sample of US veterans treated with ADT and RT for localized PCa, younger age was associated with inferior short-term PSA response and higher risk of biochemical recurrence.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
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| Enthalten in: |
BJUI compass - 3(2022), 3 vom: 20. Mai, Seite 243-250 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bryant, Alex K [VerfasserIn] |
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| Links: |
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| Themen: |
Hormone receptor agonists |
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| Anmerkungen: |
Date Revised 16.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/bco2.132 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM340209984 |
|---|
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| 100 | 1 | |a Bryant, Alex K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of age on treatment response in men with prostate cancer treated with radiotherapy |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company. | ||
| 520 | |a Objective: To analyse the effect of age at diagnosis on clinical outcomes of localized prostate cancer (PCa) treated with radiation therapy | ||
| 520 | |a Subjects and methods: We identified 12 784 patients with intermediate- or high-risk localized PCa treated with radiation therapy (RT) and neoadjuvant androgen deprivation therapy (ADT) between 2000 and 2015 from nationwide Veterans Affairs data. Patients were grouped into three age categories (≤59, 60-69, and ≥70 years old). Outcomes included immediate PSA response (3-month post-RT PSA and 2-year PSA nadir, grouped into <0.10 ng/ml, 0.10-0.49 ng/ml, and ≥0.50 ng/ml), biochemical recurrence, and PCa-specific mortality. Multivariable regression models included ordinal logistic regression for short-term PSA outcomes, Cox regression for biochemical recurrence, and Fine-Gray competing risks regression for PCa-specific mortality | ||
| 520 | |a Results: A total of 2136 patients (17%) were ≤59 years old at diagnosis, 6107 (48%) were 60-69 years old, and 4541 (36%) were ≥70 years old. Median follow-up was 6.3 years. Younger age was associated with greater odds of higher 3-month PSA group (≤59 vs. ≥70: adjusted odds ratio [aOR] 1.90, 95% CI 1.64-2.20; p < 0.001) and higher 2-year PSA nadir group (≤59 vs. ≥70: aOR 1.89, 95% CI 1.62-2.19, p < 0.001). Younger age was associated with greater risk of biochemical recurrence (≤59 vs. ≥70: adjusted hazard ratio 1.45, 95% CI 1.26-1.67, p < 0.001) but not PCa-specific mortality (p = 0.16) | ||
| 520 | |a Conclusion: In a large nationwide sample of US veterans treated with ADT and RT for localized PCa, younger age was associated with inferior short-term PSA response and higher risk of biochemical recurrence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a hormone receptor agonists | |
| 650 | 4 | |a neoadjuvant therapy | |
| 650 | 4 | |a prostatic neoplasm | |
| 650 | 4 | |a radiotherapy | |
| 650 | 4 | |a veterans | |
| 700 | 1 | |a Nelson, Tyler J |e verfasserin |4 aut | |
| 700 | 1 | |a McKay, Rana R |e verfasserin |4 aut | |
| 700 | 1 | |a Kader, A Karim |e verfasserin |4 aut | |
| 700 | 1 | |a Parsons, J Kellogg |e verfasserin |4 aut | |
| 700 | 1 | |a Einck, John P |e verfasserin |4 aut | |
| 700 | 1 | |a Kane, Christopher J |e verfasserin |4 aut | |
| 700 | 1 | |a Sandhu, Ajay P |e verfasserin |4 aut | |
| 700 | 1 | |a Mundt, Arno J |e verfasserin |4 aut | |
| 700 | 1 | |a Murphy, James D |e verfasserin |4 aut | |
| 700 | 1 | |a Rose, Brent S |e verfasserin |4 aut | |
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