Impact of Age and Life-expectancy on Treatment Receipt in High-risk Prostate Cancer

Background/Objectives: The incidence of Prostate cancer is increasing with age and active treatment of high-risk prostate cancer improves survival. However, it is uncertain how the age as contrasted with life expectancy impact treatment decision-making for men with clinically significant prostate cancer. The aim of this study was to determine whether age or life expectancy affected the treatment receipt. Participants: 541 men with high-risk localized prostate cancer (Gleason ≥ 8 or PSA > 20) diagnosed between 2007 and 2013 were recruited to the study. Measurements: Outcome variables included treatment underuse and type of definitive therapies such as radical prostatectomy, radiotherapy, androgen deprivation therapy and cryotherapy. Life expectancy was assessed according to Schonberg Prognostic Index. Results: Among the 541 high-risk prostate cancer patients, older men (≥65 years) received definitive therapy at similar rates as younger men (97% vs 98%; p=0.2), while younger men were more likely to accept surgery compared with older men (95% vs. 72%, p