ADVANCED AGE is associated with significantly higher cancer-specific mortality in men with bone-only metastatic prostate cancer, according to a large population-based analysis of data from the Surveillance, Epidemiology, and End Results database.
In this retrospective study, researchers evaluated 11,098 men diagnosed with bone-only metastatic prostate cancer between 2010 and 2022 to better understand how age influences survival outcomes. Nearly half of the cohort (48.2%) were aged 70 years or older, reflecting the predominance of older patients in this disease setting.
Age Impacts Survival in Metastatic Prostate Cancer
Findings showed a clear and progressive increase in cancer-specific mortality with advancing age. Five-year mortality rates rose from 50.2% in patients younger than 50 years to 64.8% in those aged 80 years and above (p<0.001). Importantly, this association persisted after adjusting for other clinical and demographic variables. Patients aged 80 years or older had a 78% higher risk of cancer-specific mortality compared to younger counterparts (subdistribution hazard ratio 1.78; 95% CI: 1.45–2.19).
Beyond age, several additional factors were identified as independent predictors of poorer outcomes. These included non-Hispanic Black race/ethnicity, single marital status, elevated prostate-specific antigen levels, and higher tumour grade as defined by the International Society of Urological Pathology grading system. These findings highlight the multifactorial nature of survival disparities in this patient population.
Treatment patterns were also associated with differences in mortality. Radical prostatectomy was linked to lower cancer-specific mortality, suggesting a potential survival benefit in selected patients. In contrast, radiotherapy and chemotherapy were associated with higher mortality in the overall cohort, though this likely reflects confounding by indication, with these treatments more commonly used in patients with more advanced or aggressive disease.
In subgroup analyses of patients aged 70 years and older, prostate-specific antigen levels and ISUP grade remained strong independent predictors of mortality, reinforcing their value in risk stratification among older individuals.
Age and Tumour Grade Shape Survival Outcomes
The authors conclude that advancing age is an independent determinant of worse cancer-specific outcomes in bone-only metastatic prostate cancer. They emphasise that tumour burden, pathological features, and treatment allocation all contribute to age-related disparities in survival, underscoring the need for more individualised treatment approaches in older patients.
Reference
Ozsoy C et al. Advanced age increases cancer-specific mortality in bone-only metastatic prostate cancer: a SEER analysis. Sci Rep. 2026;16:13511.
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