PATIENT AGE AS A PROGNOSTIC FACTOR IN PROSTATE-CANCER

Whether patient age per se is a prognostic factor of significance in p rostate cancer is controversial. To investigate this issue age-specifi c relative survival was analyzed, and the number of years lost due to this disease was calculated in a large and unselected cohort of 6,890 prostate cancer patients diagnosed between 1971 and 1987 in the northe rn region of Sweden. The tumor grade was derived from filed notificati on forms, which showed 26.4% well (grade 1), 40.0% moderately (grade 2 ) and 17.7% poorly (grade 3) differentiated tumors. There was an overr epresentation of grade 3 tumors among the youngest patients. The age-s pecific relative survival rate did not differ significantly among diff erent age groups and slight differences almost vanished when adjusting for tumor grade. This finding does not support the view that tumors a ppearing in younger patients are more aggressive per se. However, loss of life expectancy differed significantly among all age classes and i n all 3 grades. In patients with grade 1 tumors the years lost due to prostate cancer ranged from 11.0 to 1.2 in the youngest and oldest age strata, even though the relative survival was approximately 0.70 in a ll age classes. It was concluded that even if relative survival is con stant with patient age, the absolute impact of prostate cancer at diff erent ages varied substantially as indicated by loss of life expectanc y. This finding might indicate that younger prostate cancer patients s hould be given more aggressive treatment than older patients.