Age at diagnosis on prostate cancer survival undergoing androgen deprivation therapy as primary treatment in daily practice: results from Japanese observational cohort

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• 作者：Teruo Inamoto (1)
  Haruhito Azuma (1)
  Shiro Hinotsu (2)
  Taiji Tsukamoto (3)
  Mototsugu Oya (4)
  Osamu Ogawa (5)
  Tadaichi Kitamura (6)
  Suzuki Kazuhiro (7)
  Seiji Naito (8)
  Mikio Namiki (9)
  Kazuo Nishimura (10)
  Yoshihiko Hirao (11)
  Michiyuki Usami (10)
  Masaru Murai (12)
  Hideyuki Akaza (13)
  
• 关键词：Age at diagnosis ; CaP ; ADT
• 刊名：Journal of Cancer Research and Clinical Oncology
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：140
• 期：7
• 页码：1197-1204
• 全文大小：
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• 作者单位：Teruo Inamoto (1)
  Haruhito Azuma (1)
  Shiro Hinotsu (2)
  Taiji Tsukamoto (3)
  Mototsugu Oya (4)
  Osamu Ogawa (5)
  Tadaichi Kitamura (6)
  Suzuki Kazuhiro (7)
  Seiji Naito (8)
  Mikio Namiki (9)
  Kazuo Nishimura (10)
  Yoshihiko Hirao (11)
  Michiyuki Usami (10)
  Masaru Murai (12)
  Hideyuki Akaza (13)
  
  1. Department of Urology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
  2. Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
  3. Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
  4. Department of Urology, School of Medicine, Keio University, Tokyo, Japan
  5. Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  6. Asoka Hospital, Tokyo, Japan
  7. Department of Urology, Gunma University School of Medicine, Gunma, Japan
  8. Department of Urology, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
  9. Department of Urology, School of Medicine, Kanazawa University, Kanazawa, Japan
  10. Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  11. Osaka Gyomeikan Hospital, Osaka, Japan
  12. The International Goodwill Hospital, Yokohama, Japan
  13. Department of Strategic Investigation on Comprehensive Cancer Network, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
  
• ISSN：1432-1335

文摘

Objectives Primary androgen deprivation therapy (PADT) had been used extensively in Japan than in the USA and European countries regardless of the disease risk or patient’s age. To illustrate the consequence of PADT from daily clinical practice, we evaluated the relationship among age, disease risk, and survival of patients with prostate cancer treated by PADT in largest Asian cohort. Patients and methods The 19,246 men subjected to PADT enrolled in the Japan Study Group of Prostate Cancer were enrolled for the present analysis. Patients were divided into four groups based on age at diagnosis: age <66, 66-0, 71-5, and >75. Risk was stratified according to the Japan Cancer of the Prostate Risk Assessment (J-CAPRA). Multivariate competing risks regression analysis was performed for OS and PFS. Results There was downward stage migration over age. Among men aged >75?years, 34.1?% had nodal or distant metastatic disease. In contrast, 56.0?% of patients aged <66?years presented with advanced disease. The modality of hormonal therapy varied with age across risk groups; the younger age group showed a higher proportion of maximal androgen blockade, while the proportion of monotherapy use was higher in older men. The likelihood of low-risk disease by J-CAPRA classification increased significantly with increasing age (p?<?0.0001 by Pearson’s chi-square test). The same as OS, the PFS rate increased with age until after the age of 75. Men aged 71-5 had better survival rates even after adjustments for treatment modality alone, or for treatment modality plus disease risk. Conclusions Age cohorts do affect orientation toward favorable disease course after PADT with men aged 71-5 being benefiting more from PADT than other age groups.