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Journal of Cancer Research and Clinical Oncology

Erschienen in:

01.04.2016 | Original Article – Clinical Oncology

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

verfasst von: Joo Yong Lee, Ho Won Kang, Koon Ho Rha, Nam Hoon Cho, Young Deuk Choi, Sung Joon Hong, Kang Su Cho

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 4/2016

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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.

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Titel: 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
verfasst von: Joo Yong Lee
Ho Won Kang
Koon Ho Rha
Nam Hoon Cho
Young Deuk Choi
Sung Joon Hong
Kang Su Cho
Publikationsdatum: 01.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 4/2016
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-015-2093-0

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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