Age 70 +/- 5 Years and Cancer Specific Outcomes after Treatment of Localized Prostate Cancer: A Systematic Review
Abstract
PURPOSE
A secondary analysis of two randomized RTOG (Radiation Therapy Oncology Group) trials demonstrated that age ≥ 70 years was a favorable prognostic factor among men treated with external beam radiotherapy (EBRT). In contrast, several series based on men undergoing radical prostatectomy (RP) suggested that older age was an unfavorable prognostic factor. Our study was initiated to determine whether these observations reflect a true but paradoxical underlying age-related treatment-dependent biological phenomenon.
METHODS
We conducted a systematic review (PubMed, from 01/01/1999 to 30/1/2023) evaluating the impact of age on cancer-specific outcomes following definitive local treatment with either RP or EBRT. Our main objective was to assess possible interactions between age (using a cutoff of 70 +/- 5 years) and treatment type, with regard to adverse cancer-specific outcomes (e.g., pathology, biochemical failure (BNED), distant metastasis (DM), or prostate cancer-specific survival (PCSS).
RESULTS
Forty -five studies were selected for inclusion in this systematic review, including 30 and 15 studies with patients treated with RP and EBRT, respectively. Among patients treated by RP, 10 (50%) of these studies suggested that older age was associated with worse outcome(s) after RP. None suggested that age was a favorable prognostic factor after RP. Among the EBRT-based studies, eight (53%) suggested that older age was associated with better outcomes, with an additional 3 studies…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 15 participants or records.
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