Urological outcomes in nonagenarians with prostate cancer

  • Joshua White University of Calgary
  • Jesse Ory University of Miami
  • Heather Morris Dalhousie University
  • Ricardo A. Rendon Dalhousie University
  • Ross Mason Dalhousie University
  • Ashley Cox Dalhousie University
Keywords: Prostate Cancer, Nonagenarian, Prostate specific antigen, Androgen deprivation therapy

Abstract

Introduction: Nonagenarians represent a growing patient population. Herein, we report on the largest cohort of Canadian nonagenarian patients, to our knowledge, with prostate cancer.

Methods: A retrospective chart of 44 nonagenarian men diagnosed with localized or metastatic prostate cancer between 2006 and 2019 was performed. Diagnoses were based on pathological specimens or the presence of a high prostate-specific antigen (PSA >20) or abnormal digital rectal exam (DRE) in the setting of metastatic disease on imaging. Patient demographics, presenting complaints, and treatments required were included in the analysis. A descriptive statistical analysis was performed.

Results: The median patient age at time of referral was 91.1 years (interquartile range [IQR] 90.2–92.9). The median PSA at time of referral was 54.0 (IQR 18.2–142.6). Metastatic disease was present in 55% of patients at time of diagnosis (n=24). Most patients required at least one urological intervention (n=35). There were 56.8% of patients who received androgen deprivation therapy (ADT) as part of their treatment regime (n=25). Half (50%) of patients were managed with androgen receptor axis-targeted agents (ARAT), as well as ADT (n=22). Five patients (11.4%) underwent surgical castration. Death due to any cause was noted in 52.3% of patients (n=23) throughout the study period, with the median age at death being 94.4 years (IQR 92.3–97.0). Death due to prostate cancer was noted in 18.2% of patients (n=8).

Conclusions: This study highlights common presenting complaints for nonagenarian patients with prostate cancer and that many require urological intervention despite advanced age. Future studies should address patient-reported quality of life outcomes in the nonagenarian population with prostate cancer.

Author Biographies

Joshua White, University of Calgary

University of Calgary - Cumming School of Medicine

Class of 2017

Jesse Ory, University of Miami

Department of Urology

Heather Morris, Dalhousie University

Department of Urology

Ricardo A. Rendon, Dalhousie University

Department of Urology

Ross Mason, Dalhousie University

Department of Urology

Ashley Cox, Dalhousie University

Department of Urology

Published
2021-01-04
How to Cite
White, J., Ory, J., Morris, H., Rendon, R. A., Mason, R., & Cox, A. (2021). Urological outcomes in nonagenarians with prostate cancer . Canadian Urological Association Journal, 15(8). https://doi.org/10.5489/cuaj.6805
Section
Original Research