Among the 541 high-riskprostate cancerpatients, older men (≥65 years) received definitive therapy at similar rates as younger men (97% vs 98%; p=0.2), while younger men were more likely to accept surgery compared with older men (95% vs. 72%, p<0.001). Age affected treatment choice depending on the patient's life expectancy. Among men with higher life expectancy, age did not affectsurgery receipt (OR=0.62; 95%CI 0.18-2.20). But among men with lower life expectancy, older age (OR=0.15; 95%CI 0.06-0.38), black race (OR=0.27; 95%CI 0.10-0.77), comorbidity (OR=0.31; 95%CI 0.13-0.76) and non-commercial insurance (OR=0.12, 95%CI 0.05-0.28) were associated with lower rate of surgical receipt.