Age as a prognostic factor for disease recurrence after radical prostatectomy

Objectives. To assess whether age has an impact on biochemical recurrence a fter radical prostatectomy for localized adenocarcinoma of the prostate. Methods. Four hundred eighty-nine consecutive patients who underwent radica l retropubic prostatectomy and did not have metastases to the lymph nodes w ere retrospectively analyzed. Disease recurrence was defined as a serum pro state-specific antigen greater than 0.2 ng/mL and rising on at least two po stoperative measurements. Biochemical progression was compared in patients 70 years old or younger and older than age 70. The Kaplan-Meier estimator a nd Cox's proportional hazards model were employed to investigate the impact of age on time to recurrence. Neoadjuvant androgen deprivation was treated as a stratification variable in the Cox models. Results. The mean follow-up was 25.4 +/- 20.8 months. The Gleason score and extent of cancer in the pathologic analyses of the prostatectomy specimen was not significantly different between the two groups. Biochemical recurre nce was detected in 12% of patients 70 years old or younger and in 25% of t hose older than 70 (P = 0.01), in multivariate analyses, after adjusting fo r all prognostic factors, younger age (70 years or younger) was independent ly associated with a longer time to recurrence (P <0.02). Conclusions. Our results suggest that age per se may be an independent prog nostic factor for disease recurrence after radical prostatectomy. This impl ies that patients 70 years old or younger are more likely to benefit from s urgery. This information may be useful when counseling patients with clinic ally localized carcinoma of the prostate. (C) 1999, Elsevier Science Inc.