Favorable 15-Year Survival Outcomes for Older Prostate Cancer Patients with Low-Risk Disease

“Previous research by the study’s lead author Grace Lu-Yao, PhD, MPH, cancer epidemiologist at the Cancer Institute of New Jersey and professor of medicine at Rutgers Robert Wood Johnson Medical School, and colleagues examined 10-year outcomes for this population (JAMA, Vol. 302, No. 11). The 2009 research showed men diagnosed with prostate cancer beginning in the early 1990’s had significantly improved survival compared with patients whose cancers were diagnosed in prior decades. Given the protracted nature of the disease and increasing longevity among elderly men, 10-year follow-up may not be sufficient to make informed treatment decisions. Dr. Lu-Yao notes this new study, which extends data examination by an additional five years, ‘helps provide a more complete picture of potential outcomes for patients who have a life expectancy greater than 10 years.’

“The new research, which appears in the current online edition of European Urology (doi: 10.1016/j.eururo.2015.03.021), examined 33,137 Medicare patients aged 65 or older who were diagnosed with early-stage (T1 or T2) prostate cancer from 1992 through 2009 and received conservative management (no surgery, radiotherapy, cryotherapy or androgen deprivation therapy) within the first six months of diagnosis. The researchers utilized information from the Surveillance, Epidemiology and End Results (SEER) cancer registries and Medicare claims. All SEER registries hold the highest level of certification of data quality.

“Investigators found that men aged 64 to 74 with a Gleason score (a grading system that indicates how likely a tumor will spread) of between five and seven had a lower risk (5.7 percent) of dying from prostate cancer over a 15-year period as compared to men 75 and older, whose risk was 10.1 percent. For men with the highest level Gleason scores (between eight and 10), 15-year prostate cancer mortality rates were 22 percent for men aged 65 to 74 and 27 percent for men 75 and older.”


Adjuvant Chemotherapy May Improve Lung Cancer Outcomes in Older Patients

“Adjuvant chemotherapy may improve survival for older patients with stage I non–small cell lung cancer, according to an analysis of the SEER–Medicare database.

“However, the regimen also is associated with serious adverse events, according to an analysis of the SEER-Medicare database.

“Weighing the risks vs. benefits of adjuvant chemotherapy is more difficult in older patients, as they have a greater risk for disease recurrence after surgical resection but also have a more limited life expectancy.

“Jyoti Malhotra, MD, of the department of hematology and oncology at Tisch Cancer Institute at Icahn School of Medicine at Mount Sinai, and colleagues conducted a population-based study to compare survival and rates of serious adverse events among elderly patients with T2N0 NSCLC. The analysis included 3,289 patients aged older than 65 years who were treated between 1992 and 2009. All patients had tumors at least 4 cm, and they underwent surgical resection followed by either observation or adjuvant platinum chemotherapy with or without postoperative radiation.”