. 2022 Jun 15;11(12):3451.

doi: 10.3390/jcm11123451.

The Latest Data Specifically Focused on Long-Term Oncologic Prognostication for Very Old Adults with Acute Vulnerable Localized Prostate Cancer: A Nationwide Cohort Study

Szu-Yuan Wu^{1

2

3

4

5

6

7}, Fransisca Fortunata Effendi^{8

9}, Ricardo E Canales^{8

10}, Chung-Chien Huang^{11

12

13

14}

Affiliations

¹ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
² Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
³ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁴ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁵ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁶ Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei 242, Taiwan.
⁷ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
⁸ School of Health Care Administration, Department of Health Care Administration, College of Management, Taipei Medical University, Taipei 110, Taiwan.
⁹ PT Inertia Utama, Dexa Group, Jl. Boulevard Bintaro Jaya, Pondok Jaya, Pondok Aren, South Tangerang 15117, Indonesia.
¹⁰ Collegiate of Doctors in Honduras, Colegio Médico de Honduras (CMH), CA 6 Boulevard Fuerzas Armadas, Tegucigalpa 11101, Honduras.
¹¹ Biotech and Healthcare Management, School of Health Care Administration, College of Management, Taipei Medical University, Taipei 110, Taiwan.
¹² Department of Medical Quality, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
¹³ Department of Long-Term Care & School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei 110, Taiwan.
¹⁴ Department & School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan.

PMID: 35743522
PMCID: PMC9225393
DOI: 10.3390/jcm11123451

The Latest Data Specifically Focused on Long-Term Oncologic Prognostication for Very Old Adults with Acute Vulnerable Localized Prostate Cancer: A Nationwide Cohort Study

Szu-Yuan Wu et al. J Clin Med. 2022.

. 2022 Jun 15;11(12):3451.

doi: 10.3390/jcm11123451.

Authors

Szu-Yuan Wu^{1

2

3

4

5

6

7}, Fransisca Fortunata Effendi^{8

9}, Ricardo E Canales^{8

10}, Chung-Chien Huang^{11

12

13

14}

Affiliations

¹ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
² Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
³ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁴ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁵ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁶ Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei 242, Taiwan.
⁷ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
⁸ School of Health Care Administration, Department of Health Care Administration, College of Management, Taipei Medical University, Taipei 110, Taiwan.
⁹ PT Inertia Utama, Dexa Group, Jl. Boulevard Bintaro Jaya, Pondok Jaya, Pondok Aren, South Tangerang 15117, Indonesia.
¹⁰ Collegiate of Doctors in Honduras, Colegio Médico de Honduras (CMH), CA 6 Boulevard Fuerzas Armadas, Tegucigalpa 11101, Honduras.
¹¹ Biotech and Healthcare Management, School of Health Care Administration, College of Management, Taipei Medical University, Taipei 110, Taiwan.
¹² Department of Medical Quality, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
¹³ Department of Long-Term Care & School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei 110, Taiwan.
¹⁴ Department & School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan.

PMID: 35743522
PMCID: PMC9225393
DOI: 10.3390/jcm11123451

Abstract

Purpose: Few studies have evaluated the prime treatment choice for men older than 80 years with acute vulnerable localized prostate cancer (AV-LPC). Clinicians have been deeply troubled by this near end-of-life medical choice for a very specific group of patients. We compared the oncological prognostication of very old patients with AV-LPC after they underwent either radical prostatectomy (RP) or massive-dose intensity-modulated radiotherapy (IMRT) coupled with long-term androgen deprivation therapy (ADT) over a long-term investigation. Methods: In this nationwide cohort study, we used the Taiwan Cancer Registry Database and retrieved information related to patients (aged ≥ 80 years) with AV-LPC who underwent standard RP (the RP group) or massive-dose IMRT + long-term ADT (at least 72 Gy and ADT use ≥18 months; the IMRT + ADT group). After potential confounders were controlled for using propensity score matching (PSM), we utilized the Cox proportional hazards regression to evaluate the oncologic prognostication. Results: The IMRT + ADT group had a significantly higher adjusted hazard ratio (aHR) for all-cause mortality (aHR, 2.00; 95% confidence interval [CI], 1.41−2.87) than the RP group. Analysis of the secondary outcomes revealed that compared with the RP group, the aHRs of biochemical failure, locoregional recurrence, and distant metastasis in the IMRT + ADT group were 1.77 (95% CI: 1.36−2.11, p < 0.0001), 1.12 (95% CI: 1.04−1.33, p < 0.0001), and 1.15 (95% CI: 1.06−1.71, p = 0.0311), respectively. Conclusion: RP provides more favorable oncological prognostication than IMRT in very old adults with AV-LPC.

Keywords: acute vulnerable; intensity-modulated radiotherapy; oncologic prognostication; prostate cancer; radical prostatectomy.

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Conflict of interest statement

The authors have no potential conflict of interest to declare. The data sets supporting the study conclusions are included in the manuscript.

Figures

**Figure 1**
Plots of survival for outputs of patient with AV-LPC receiving different curative-intent treatments utilizing the Kaplan–Meier method: Propensity score-matching.

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The Latest Data Specifically Focused on Long-Term Oncologic Prognostication for Very Old Adults with Acute Vulnerable Localized Prostate Cancer: A Nationwide Cohort Study

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The Latest Data Specifically Focused on Long-Term Oncologic Prognostication for Very Old Adults with Acute Vulnerable Localized Prostate Cancer: A Nationwide Cohort Study

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