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Age-adjusted Charlson comorbidity index is a significant prognostic factor for long-term survival of patients with high-risk prostate cancer after radical prostatectomy: a Bayesian model averaging approach.

Authors
 Joo Yong Lee  ;  Ho Won Kang  ;  Koon Ho Rha  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Sung Joon Hong  ;  Kang Su Cho 
Citation
 Journal of Cancer Research and Clinical Oncology, Vol.142(4) : 849-858, 2016 
Journal Title
 Journal of Cancer Research and Clinical Oncology 
ISSN
 0171-5216 
Issue Date
2016
MeSH
Age Factors ; Aged ; Bayes Theorem ; Biomarkers, Tumor/blood* ; Comorbidity ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prostate-Specific Antigen/blood* ; Prostatectomy* ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/mortality* ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Risk Factors
Keywords
Bayes theorem ; Comorbidity ; Mortality ; Prostatic neoplasms ; Risk
Abstract
PURPOSE: We investigated the long-term prognostic impact of age-adjusted Charlson comorbidity index (ACCI) on overall mortality (OM), cancer-specific mortality (CSM), and other-cause mortality (OCM) according to risk stratification in patients with prostate cancer who underwent radical prostatectomy. METHODS: Data from 542 patients who underwent radical prostatectomy between 1992 and 2006 were analyzed. The impact of preoperative variables including age, prostate-specific antigen, biopsy Gleason sum, clinical stage, and ACCI on OM, CSM, and OCM were analyzed according to risk groups, with a median follow-up of 101 months. RESULTS: Subjects were stratified into either the high-risk group (n = 241) or the non-high-risk group (n = 301). Cox proportional hazards model demonstrated that the ACCI was the only significant predictor for OM in all patients (hazard ratio, HR 1.41; 95 % confidence interval, CI 1.19-1.66), non-high-risk group (HR 1.45; 95 % CI 1.09-1.91), and high-risk group (HR 1.37; 95 % CI 1.11-1.69). In competing risk analysis, CSM was not associated with the ACCI in either risk group. However, the ACCI had a significant impact on OCM in both the non-high-risk (HR 1.55; 95 % CI 1.16-2.1) and high-risk groups (HR 1.60; 95 % CI 1.23-2.08). A Bayesian model averaging approach verified that the ACCI was the most powerful predictor for OM and OCM in the both high-risk and non-high-risk groups. CONCLUSIONS: A thorough assessment of comorbidities is mandatory in establishing prognoses, even when considering invasive treatment modalities in high-risk prostate cancer patients.
Full Text
http://link.springer.com/article/10.1007/s00432-015-2093-0
DOI
10.1007/s00432-015-2093-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
이주용(Lee, Joo Yong) ORCID logo https://orcid.org/0000-0002-3470-1767
조강수(Cho, Kang Su) ORCID logo https://orcid.org/0000-0002-3500-8833
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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URI
http://hdl.handle.net/22282913/146484
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