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Impact of charlson comorbidity index varies by age in patients with prostate cancer treated by radical prostatectomy: A competing risk regression analysis

 Joo Yong Lee  ;  Dae Hun Lee  ;  Nam Hoon Cho  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Sung Joon Hong  ;  Seung Choul Yang  ;  Kang Su Cho 
 ANNALS OF SURGICAL ONCOLOGY, Vol.21(2) : 677-683, 2014 
Journal Title
Issue Date
Age Factors ; Aged ; Aged, 80 and over ; Comorbidity ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prognosis ; Prostate-Specific Antigen/analysis ; Prostatectomy* ; Prostatic Neoplasms/epidemiology* ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/surgery* ; Regression Analysis ; Republic of Korea/epidemiology ; Risk Assessment ; Survival Rate
Prostate Cancer ; Radical Prostatectomy ; Charlson Comorbidity Index ; Charlson Comorbidity Index Score ; Prostate Cancer Mortality
PURPOSE: To investigate the prognostic impact of the Charlson comorbidity index (CCI) on either cancer-specific mortality (CSM) or other-cause mortality (OCM) according to age in patients with prostate cancer (PC) who underwent radical prostatectomy (RP). METHODS: Data from 336 patients who underwent RP for PC between 1992 and 2005 were analyzed. Variables, including the preoperative prostate-specific antigen (PSA), prostate volume, clinical stage, and pathologic stage, were compared across age groups (<65 or ≥65 years old). Preexisting comorbidities were evaluated by the CCI, and patients were classified into two CCI score categories (0 or ≥1). RESULTS: The median (interquartile range) follow-up period was 96 (85-121) months. Subjects were divided into two subgroups according to age: <65 years (n = 151) or ≥65 years (n = 185). There was no significant difference in PSA, biopsy Gleason sum, body mass index, pathologic stage, or CCI between the two age groups. OCM was significantly associated with the CCI score (P = 0.011). Cumulative incidence estimates obtained from competing risk regression analysis indicated that CCI was not associated with CSM (P = 0.795) or OCM (P = 0.123) in the ≥65-year group. However, in men <65 years, cumulative incidence estimates for OCM were significantly associated with CCI (P = 0.036). CONCLUSIONS: CCI was independently associated with OCM after RP, but only in men <65 years old. CCI was not associated with CSM in either age group. Accordingly, a thorough evaluation of patient's comorbidities is mandatory when considering aggressive surgical treatment, especially in relatively young patients.
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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
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yang, Seung Choul(양승철)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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