Estramustine phosphate combined with orchidectomy as first-line therapy in patients with prostate carcinoma. Effect of age on survival

BACKGROUND: The role of age as a prognostic factor for survival remains debatable in patients with prostate carcinoma. METHODS: The authors conducted a retrospective study of the significance of age as a prognostic factor for survival and progression free survival in 386 patients who underwent orchidectomy for locally advanced or metastatic prostate carcinoma, 75% of whom had T0-T4, M1 disease. After undergoing orchidectomy, 192 patients received no further therapeutic intervention, whereas 194 patients received additional treatment with estramustine phosphate (EMP) as first-line therapy. RESULTS: The findings confirmed that age was a significant prognostic factor for survival and progression free survival in patients with prostate carcinoma as well as a predictor of response to chemotherapy. The data also showed that, although combining orchidectomy with EMP appeared to be beneficial in younger patients, using this relatively more aggressive therapeutic approach as first-line therapy in older patients (age > or = 80 years) may shorten their survival. CONCLUSIONS: The current findings call for caution with the additional use of EMP as first-line therapy in older patient with prostate carcinoma