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Brief Correspondence

Validation of an Age-adjusted Prostate Cancer–Specific Comorbidity Index

By: Michael Froehnera , Rainer Kochb, Matthias Hüblerc and Manfred P. Wirtha

European Urology, Volume 69 Issue 5, May 2016, Pages 764-766

Published online: 01 May 2016

Keywords: Urologic neoplasms, Comorbidity, Prostate cancer, Radical prostatectomy, Mortality, Bladder, Competing risk analysis

Abstract Full Text Full Text PDF (254 KB) Patient Summary

Abstract

Estimating competing mortality is of paramount importance for prostate cancer screening candidates and men with early prostate cancer. An age-adjusted prostate cancer–specific comorbidity index (PCCI) was developed recently for this purpose in an unselected population of 1598 men. We validated this mortality index in a sample of 2961 patients who consecutively underwent radical prostatectomy between 1992 and 2007 at our institution. In patients with a PCCI of 0, 1–2, 3–4, 5–6, 7–9, and ≥10 who were selected for radical prostatectomy, the 10-yr competing mortality rates were 2%, 9%, 17%, 27%, 56%, and 0% (n = 3), respectively, compared with 10%, 19%, 35%, 60%, 79%, and 99%, respectively, in the unselected development cohort. The PCCI is well suited to stratify patients with prostate cancer according to their risk of competing mortality. In candidates for radical prostatectomy, however, the 10-yr competing mortality rates are approximately half as high as in unselected patients with the same PCCI risk level.

Patient summary

With stratification by the age-adjusted prostate cancer–specific comorbidity index, the 10-yr competing mortality rate in men selected for radical prostatectomy is approximately half as high as in unselected patients at the same level of comorbid risk.

Take Home Message

The prostate cancer–specific comorbidity index (PCCI) is well suited to stratify patients with prostate cancer according to their risk of competing mortality. In candidates for radical prostatectomy, however, the 10-yr competing mortality rates are only half as high as in unselected patients with the same PCCI risk level.

Keywords: Urologic neoplasms, Comorbidity, Prostate cancer, Radical prostatectomy, Mortality, Bladder, Competing risk analysis.

Footnotes

a Department of Urology, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany

b Department of Medical Statistics and Biometry, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany

c Department of Anesthesiology, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany

Corresponding author. Department of Urology, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany. Tel. +49 351 4587462; Fax: +49 351 4584333.

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