Primary management and survival of non-metastatic prostate cancer in subjects aged 75 years old and over. Analysis of data from a French cancer registry.

BACKGROUND: In older men, non-metastatic prostate cancer (NMPC) may be under or overtreated, and curative treatments are rarely achieved. OBJECTIVES: The aim of this study was to analyze the primo-management and survival of non-metastatic prostate cancers in subjects aged 75 and over in a French department. METHODS: We used retrospective, population-based data to identify subjects aged 75 and over at diagnosis with NMPC between 1 January 2017 and 31 December 2020. Patients were divided into 2 groups: group 1, patients aged 75 to 79 years, and group 2, patients aged 80 years and over. RESULTS: We included 1077 patients, 606 in group 1 and 471 in group 2. Of the 794 patients diagnosed on prostate biopsies, 73.7% in group 1 and 35.1% in group 2 received a local curative treatment (p<0.001). Of the 219 NMPC patients diagnosed for a benign prostate hypertrophy (BPH), 73% in group 1 and 69.5% in group 2 were placed on WW after diagnosis and 13.5% in group 1 and 3.7% in group 2 had an active surveillance. Men in group 2 were more frequently put on androgen deprivation therapy (21.3% vs. 5.4%). CONCLUSIONS: Patients aged 80 and over received fewer local curative treatments, and hormone therapy was overused. In our study, patients with a local curative treatment strategy had a better survival in both age groups. Treatment decisions for these patients should not be based on chronological age, but on cancer prognosis and life expectancy.