Older patients with low Charlson score and high-risk prostate cancer benefit from radical prostatectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-10

AUTHORS

A. Sivaraman, G. Ordaz Jurado, X. Cathelineau, Eric Barret, P. Dell’Oglio, S. Joniau, M. Bianchi, A. Briganti, M. Spahn, P. Bastian, J. Chun, P. Chlosta, P. Gontero, M. Graefen, R. Jeffrey Karnes, G. Marchioro, B. Tombal, L. Tosco, H. Henk van der Poel, R. Sanchez-Salas

ABSTRACT

INTRODUCTION: The aim of the study was to identify the appropriate level of Charlson comorbidity index (CCI) in older patients (>70 years) with high-risk prostate cancer (PCa) to achieve survival benefit following radical prostatectomy (RP). METHODS: We retrospectively analyzed 1008 older patients (>70 years) who underwent RP with pelvic lymph node dissection for high-risk prostate cancer (preoperative prostate-specific antigen >20 ng/mL or clinical stage ≥T2c or Gleason ≥8) from 14 tertiary institutions between 1988 and 2014. The study population was further grouped into CCI < 2 and ≥2 for analysis. Survival rate for each group was estimated with Kaplan-Meier method and competitive risk Fine-Gray regression to estimate the best explanatory multivariable model. Area under the curve (AUC) and Akaike information criterion were used to identify ideal 'Cut off' for CCI. RESULTS: The clinical and cancer characteristics were similar between the two groups. Comparison of the survival analysis using the Kaplan-Meier curve between two groups for non-cancer death and survival estimations for 5 and 10 years shows significant worst outcomes for patients with CCI ≥ 2. In multivariate model to decide the appropriate CCI cut-off point, we found CCI 2 has better AUC and p value in log rank test. CONCLUSION: Older patients with fewer comorbidities harboring high-risk PCa appears to benefit from RP. Sicker patients are more likely to die due to non-prostate cancer-related causes and are less likely to benefit from RP. More... »

PAGES

1367-1372

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-016-1784-8

DOI

http://dx.doi.org/10.1007/s00345-016-1784-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039844560

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26897499


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