Effects of radical prostatectomy on survival in elderly patients aged 75 years and over

Objective To investigate the effects of radical prostatectomy on the overall survival(OS)and tumor-specific survival in prostate cancer(PCa)patients aged 75 years and older. Methods Clinical data of patients aged 75 and older with localized PCa from Surveillance, Epidemiology, and End Results (SEER)Database from 2004 to 2016 were retrospectively analyzed.There were 17 899 cases of PCa undergoing radical prostatectomy and 3 648 cases of PCa without surgery in this study.The OS and prostate cancer-specific survival(PSS)were compared between the surgery group and the non-surgery group. Results For 75-79-year-old patients with high-risk localized PCa, the OS and PSS in the surgery group were better than in the non-surgery group(OR=1.49, 95%CI: 1.22~1.82, P 0.05). Conclusions Age limits for prostatectomy should be extended as a result of increasing average life expectancy.Patients aged 75-79 years with high-risk PCa can be considered for surgical treatment, while it should not be recommended for patients aged 75-79 years with low-or medium-risk localized PCa or aged more than 80 years.Many factors should be considered in making treatment decisions for prostate cancer. Key words: Prostate neoplasms; Transurethral resection of prostate; Survival analysis