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Journal of Cancer Research and Clinical Oncology

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07.02.2018 | Original Article – Cancer Research

Impact of comorbidities at diagnosis on prostate cancer treatment and survival

verfasst von: Katarina Luise Matthes, Manuela Limam, Giulia Pestoni, Leonhard Held, Dimitri Korol, Sabine Rohrmann

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 4/2018

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Abstract

Background

The aim of this study was to assess the associations of comorbidities with primary treatment of prostate cancer (PCa) patients and of comorbidities with PCa-specific mortality (PCSM) compared to other-cause mortality (OCM) in Switzerland.

Patients and methods

We included 1527 men diagnosed with PCa in 2000 and 2001 in the canton of Zurich. Multiple imputation methods were applied to missing data for stage, grade and comorbidities. Multinomial logistic regression analyses were used to explore the associations of comorbidities with treatment. Cox regression models were used to estimate all-cause mortality, and Fine and Gray competing risk regression models to estimate sub-distribution hazard ratios for the outcomes PCSM and OCM.

Results

Increasing age was associated with a decreasing probability of receiving curative treatment, whereas an increasing Charlson Comorbidity Index (CCI) did not influence the treatment decision as strongly as age. The probability of OCM was higher for patients with comorbidities compared to those without comorbidities [CCI 1: hazard ratio 2.07 (95% confidence interval 1.51–2.85), CCI 2+: 2.34 (1.59–3.44)]; this was not observed for PCSM [CCI 1: 0.79 (0.50–1.23), CCI 2+: 0.97 (0.59–1.59)]. In addition, comorbidities had a greater impact on the patients’ mortality than age.

Conclusions

The results of the current study suggest that chronological age is a stronger predictor of treatment choices than comorbidities, although comorbidities have a larger influence on patients’ mortality. Hence, inclusion of comorbidities in treatment choices may provide more appropriate treatment for PCa patients to counteract over- or undertreatment.

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Titel: Impact of comorbidities at diagnosis on prostate cancer treatment and survival
verfasst von: Katarina Luise Matthes
Manuela Limam
Giulia Pestoni
Leonhard Held
Dimitri Korol
Sabine Rohrmann
Publikationsdatum: 07.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 4/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-018-2596-6

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Springer Medizin

Impact of comorbidities at diagnosis on prostate cancer treatment and survival

Abstract

Background

Patients and methods

Results

Conclusions

Neu im Fachgebiet Onkologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Update Onkologie

Springer Medizin

Abstract

Background

Patients and methods

Results

Conclusions

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