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Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients

Authors
 Jae Won Park  ;  Dong Hoon Koh  ;  Won Sik Jang  ;  Joo Yong Lee  ;  Kang Su Cho  ;  Won Sik Ham  ;  Koon Ho Rha  ;  Woo Hee Jung  ;  Sung Joon Hong  ;  Young Deuk Choi 
Citation
 PLoS One, Vol.13(6) : e0199365, 2018 
Journal Title
 PLoS One 
Issue Date
2018
Abstract
PURPOSE: Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). MATERIALS AND METHODS: We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010. Very high-risk PC was defined according to National Comprehensive Cancer Network guidelines. Patients with incomplete medical records or who had received neoadjuvant therapy were excluded. Preoperative comorbidity was evaluated by the ACCI, and the prognostic efficacy of the ACCI was analyzed using univariable and multivariable Cox regression, competing risk regression model and Kaplan-Meier curves. RESULTS: Our final analysis included 228 men with a median age of 66 years (interquartile range 62-71) and median prostate specific antigen of 10.7 ng/mL. There were 41 (18%) patients with an ACCI score >3 and 88 (38.6%) patients with a biopsy Gleason score >8. Preoperative evaluation revealed that 159 patients (69.7%) had a non-organ confined tumor (>/=T3). Following RP, 8-year prostate cancer-specific survival (PCSS) and overall survival (OS) rates were 91.6% and 83.4%, respectively. Competing risk regression analysis revealed that ACCI was significantly associated with other-cause survival and OS (p<0.05). CONCLUSION: The ACCI is an effective prognostic factor for other-cause survival and OS in very high-risk PC patients. RP should be considered carefully for patients with an ACCI score >3.
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DOI
10.1371/journal.pone.0199365
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
고동훈(Koh, Dong Hoon)
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박재원(Park, Jae Won)
이주용(Lee, Joo Yong) ORCID logo https://orcid.org/0000-0002-3470-1767
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
정우희(Jung, Woo Hee)
조강수(Cho, Kang Su) ORCID logo https://orcid.org/0000-0002-3500-8833
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162555
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