OBJECTIVES : As the average life expectancy of Koreans increases, the incidence of prostate cancer (Pca) is increasing in elderly. But, in the absence of evidence of primary treatment for elder patients was unable to health policy for Pca. The aim of this study was to analyze a comparative survival analysis between primary androgen deprivation therapy (PADT) and radical prostatectomy (RP) for older than 75 years with Pca in Korea.

METHODS : The primary treatment of Pca was analyzed by using the linked data of the Korea Central Cancer Registry and National Health Insurance Service (NHIS), using International Classification of Diseases, 10th diagnosis codes. To analyze the status of medical use of Pca, the database of NHIS claims in 2007–2014 was used. Kaplan-Meier (KM) and multivariate survival analyses by cancer stage were performed using a cox proportional-hazards model.

RESULTS : As a result of comparing the 5-year survival rate by summary stage in the group aged 75 or more, the survival rate of RP group in ‘Localized’ was 79% and that of PADT group was 72%. The survival rate of RP group in ‘Regional’ was 84% and that of PADT group was 55%. Also, as a result of estimating the death risk ratio between PADT group and RP group by applying the Cox proportional hazard model, in case of ‘Localized’ in summary stage, the death risk ratio of PADT group was 1.8 times higher than that of RP group (HR=1.81, 95% CI 1.01-3.25).

CONCLUSIONS : Our study showed that 5-year survival rate of hormonal therapy group in elderly with prostate cancer was lower than that of surgical therapy group. Hormonal therapy in elderly than 75 years with Pca is not established as a primary treatment of Pca, and it was differences from the study of Japanese.