Many patients with prostate cancer have other conditions or comorbidities that can impact cancer treatment choice. Researchers assessed different comorbidities and found that age was a strong predictor of treatment choice for localized prostate cancer. The results of the study were presented at the 2019 ASCO Annual Meeting.
Researchers identified 10,281 men with localized prostate cancer from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who were diagnosed between 1994 and 2014. Treatment was classified as curative (radical prostatectomy or radiation therapy with curative intent) or non-curative (all other modalities).
Almost half of patients (48.3%) had a Charlson Comorbidity Index (CCI) score of ≥1. Most men received curative treatment (75.2%), and radiation therapy was more common than radical prostatectomy (55.2% vs. 44.8%).
The likelihood of patients receiving curative treatment decreased with increasing age: Compared with men 55 to 64 years, odds ratios (ORs) for curative treatment were 0.63 at 65 to 69 years (95% confidence interval [CI], 0.52-0.76), 0.36 at 70 to 74 years (95% CI, 0.30-0.43), and 0.13 at ≥75 years (95% CI, 0.11-0.16). Men with a CCI ≥2 were less likely to receive curative treatment than men with a score of zero (OR=0.84; 95% CI, 0.74-0.96).
Among those receiving curative treatment, older age was strongly associated with radiation therapy. Compared with men 55 to 64 years, men aged 65 to 69 years (OR=2.0; 95% CI, 1.72-2.3), 70 to 74 years (OR=5.3; 95% CI, 4.5-6.3), and ≥75 years (OR=25.0; 95% CI, 17-33) were more likely to receive radiation therapy than radical prostatectomy. Men with a CCI of one (OR=1.16; 95% CI, 1.03-1.30) or ≥2 (OR=1.92; 95% CI, 1.6-2.3) were also more likely to receive radiation therapy.
Age and CCI were not significantly linked.
Pinsky PF, Pierre-Victor D, Martin IK, et al. Impact of comorbidity and age on treatment choice among men with localized prostate cancer. Abstract #e16585. Presented at the 2019 ASCO Annual Meeting, Chicago, IL, May 31-June 4, 2019.