Does age influence the behaviour of localized prostate cancer?

Objective To assess, in a meta-analysis of published studies, whether age i nfluences the behavior of localized prostate cancer. Methods The Medline database was searched from 1966 to 2000 to identify stu dies analysing the outcome of localized prostate cancer by age, using disea se-specific outcome measures, and having controlled for the established pro gnostic factors of grade, T stage and, where available, serum prostate-spec ific antigen (PSA) level. Results In all, 34 studies were identified, which included a total of 27 55 1 patients. The incomplete and heterogeneous nature of the reports preclude d any quantitative overview. The findings of these reports are described an d methodological shortcomings discussed. Conclusion The evidence suggests that young age was an adverse prognostic f actor in some series of radiation therapy before the advent of PSA assays, when men typically presented clinically with locally advanced disease, but that age has no significant prognostic effect in contemporary series of loc alized prostate cancer. Possible explanations for this difference are discu ssed, together with implications for further studies.