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Effects of age and comorbidity on survival vary according to risk grouping among patients with prostate cancer treated using radical prostatectomy: A retrospective competing-risk analysis from the K-CaP registry.

 Yoon Soo Hah  ;  Kwang Suk Lee  ;  In Young Choi  ;  Ji Youl Lee  ;  Jun Hyuk Hong  ;  Choung-Soo Kim  ;  Hyun Moo Lee  ;  Sung Kyu Hong  ;  Seok-Soo Byun  ;  Seung Hwan Lee  ;  Koon Ho Rha  ;  Byung Ha Chung  ;  Kyo Chul Koo 
 MEDICINE, Vol.97(42) : e12766, 2018 
Journal Title
Issue Date
Age Factors* ; Aged ; Comorbidity ; Databases, Factual ; Humans ; Male ; Prognosis ; Prostatectomy/methods ; Prostatectomy/mortality* ; Prostatic Neoplasms/etiology ; Prostatic Neoplasms/mortality* ; Prostatic Neoplasms/surgery ; Registries ; Regression Analysis ; Republic of Korea ; Retrospective Studies ; Risk Assessment/statistics & numerical data* ; Risk Factors ; Survival Analysis
comorbidity ; prognosis ; prostatic neoplasm ; survival
A multicenter Korean Prostate Cancer Database (K-CaP) has been established to provide information regarding Korean patients with prostate cancer (PCa). We used the K-CaP registry to investigate the value of age and comorbidity for predicting cancer-specific mortality (CSM) and other-cause mortality (OCM) according to risk grouping.The K-CaP registry includes 2253 patients who underwent radical prostatectomy (RP) between May 2001 and April 2013 at 5 institutions. Preoperative clinicopathologic data were collected and stratified according to the National Comprehensive Cancer Network risk criteria. Survival was evaluated using Gray's modified log-rank test according to risk category, age (<70 years vs ≥70 years), and Charlson comorbidity index (CCI) (0 vs ≥1).The median follow-up was 55.0 months (interquartile range: 42.0-70.0 months). Competing-risk regression analysis revealed that, independent of CCI, ≥70-year-old high-risk patients had significantly greater CSM than <70-year-old high-risk patients (P = .019). However, <70-year-old high-risk patients with a CCI of ≥1 had similar CSM relative to ≥70-year-old patients. Survival was not affected by age or CCI among low-risk or intermediate-risk patients. Multivariate analysis revealed that a CCI of ≥1 was independently associated with a higher risk of CSM (P = .003), while an age of ≥70 years was independently associated with a higher risk of OCM (P = .005).Age and comorbidity were associated with survival after RP among patients with high-risk PCa, although these associations were not observed among low-risk or intermediate-risk patients. Therefore, older patients with high-risk diseases and greater comorbidity may require alternative multidisciplinary treatment.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Hah, Yoon Soo(하윤수)
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