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concomitant d’un trouble cognitif doit être réalisé à l’aide du mini-Cog, mais le dépistage systématique d’un trouble cognitif ne semble pas pertinent [455]. Les patients dont le score G8 est inférieur à 14 ou qui paraissent vulnérables au FOLQLFLHQMXVWLÀHQWG·XQH(*>@
'LDJQRVWLF : les modalités diagnostiques n’ont pas de VSpFLÀFLWpFKH]OHVXMHWkJp/DSUREDELOLWpTXHOHGLDJQRVWLF d’un CaP se fasse sous une forme agressive augmente avec O·kJH>@2UTXHOTXHVRLWO·kJHGXSDWLHQWSRXUXQJUDGH ,683OHULVTXHGHGpFqVVSpFLÀTXHHVWWUqVpOHYpGDQV les 10 ans et même les 5 ans suivant le diagnostic [458,459].
7UDLWHPHQW OD PRUWDOLWp VSpFLÀTXH GX &D3 FRPPH des cancers en général, augmente avec l’âge au diagnos-tic [460,461]. Pour les cancers à haut risque, le risque de GpFqVUHVWHSRUWpHVVHQWLHOOHPHQWSDUOHVGpFqVVSpFLÀTXHV pendant environ 5 à 10 ans en cas de faible comorbidité, pendant plus de 5 ans en cas de comorbidité intermé-diaire et encore pendant 3 à 5 ans en cas de comorbidité pOHYpH >@ &HWWH ©VXUPRUWDOLWpª VSpFLÀTXH FKH] OHV patients âgés trouve son explication par la combinaison d’un diagnostic sous forme de moins bon pronostic et par XQ©VRXVWUDLWHPHQWª>@
Il n’existe que des études rétrospectives et observa-tionnelles concernant le CaP du patient âgé, tant localisé que métastatique, sensible à la castration et résistant à la castration ; aucune étude prospective randomisée n’a été SXEOLpH6LO·HIÀFDFLWpGHVWUDLWHPHQWVVHPEOHFRQVWDQWH avec l’augmentation de l’âge des patients, les complications de tous les traitements augmentent avec l’âge des patients (Tableau 52).
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Christophe Hennequin : consultant Amgen, Astellas, Bayer,
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Luc Cormier : Janssen, Astellas, Sanofi, Ipsen, Bayer, Recordati, ferring.
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Guillaume Ploussard : invitation congrès Astellas, Janssen, 6DQRÀ)HUULQJ,SVHQ$VWUD=HQHFD7DNHGDDGYLVRU\ERDUG
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$VWHOODV-DQVVHQ6DQRÀ)HUULQJ,SVHQ$VWUD=HQHFD7DNHGD Romain Mathieu : consultant Astellas, AstraZeneca, Ferring, Ipsen, Janssen, MSD, Takeda ; orateur Astellas, Ferring, ,SVHQ-DQVVHQ06'6DQRÀ7DNHGD
Raphaële Renard-Penna : Astellas, Takeda.
Laurent Brureau : Ipsen, Janssen, Astellas, AMGEN.
$UQDXG0pMHDQLQWHUYHQWLRQV3À]HU)HUULQJ,SVHQ%06 Olivier Cussenot : Astellas, Astra, Janssen, Ipsen, Mylan.
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Alexandre Cochet : aucun.
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[4] 2K 0$ONKXVKD\P 1 )DOODWDK 6$OWKDJDÀ$$OMDGHHG 5 Alsowaida Y, et al. The association of BRCA1 and BRCA2 mutations with prostate cancer risk, frequency, and mortality:
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>@ Schumacher FR, Al Olama AA, Berndt SI, Benlloch S, Ahmed M, Saunders EJ, et al. Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci. Nat
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(YLGHQFH IRU 3URVWDWHVSHFLÀF$QWLJHQ 6FUHHQLQJ LQ %5&$
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