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• W2023803153 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (I)1 Apr 201358 AGE, COMORBIDITY, AND RISK OF OTHER-CAUSE MORTALITY: FOURTEEN-YEAR RESULTS FROM THE PROSTATE CANCER OUTCOMES STUDY (PCOS) Timothy J. Daskivich, Kang-Hsien Fan, Tatsuki Koyama, Peter C. Albertsen, Michael Goodman, Ann S. Hamilton, Richard M. Hoffman, Janet L. Stanford, Antoinette M. Stroup, Mark S. Litwin, and David F. Penson Timothy J. DaskivichTimothy J. Daskivich Los Angeles, CA More articles by this author , Kang-Hsien FanKang-Hsien Fan Nashville, TN More articles by this author , Tatsuki KoyamaTatsuki Koyama Nashville, TN More articles by this author , Peter C. AlbertsenPeter C. Albertsen Farmington, CT More articles by this author , Michael GoodmanMichael Goodman Atlanta, GA More articles by this author , Ann S. HamiltonAnn S. Hamilton Los Angeles, CA More articles by this author , Richard M. HoffmanRichard M. Hoffman Albuquerque, NM More articles by this author , Janet L. StanfordJanet L. Stanford Seattle, WA More articles by this author , Antoinette M. StroupAntoinette M. Stroup Salt Lake City, UT More articles by this author , Mark S. LitwinMark S. Litwin Los Angeles, CA More articles by this author , and David F. PensonDavid F. Penson Nashville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1434AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with multiple comorbidities are overtreated for early-stage prostate cancer due to poor understanding of life expectancy associated with comorbidity. We sought to define the risk of other-cause mortality associated with age and comorbidity count in a population-based cohort of men with early-stage disease. METHODS We sampled 3,183 men with non-metastatic prostate cancer from PCOS. Comorbidity was measured as a count of the presence of 12 medical conditions at diagnosis: Diabetes, Stroke, Myocardial Infarction, Ulcer, Congestive Heart Failure, Angina, Liver Disease, Arthritis, Hypertension, Depression, Inflammatory Bowel Disease, and Chronic Lung Disease. We used competing risks analysis to determine risk of other-cause mortality by comorbidity count at ages 55, 65, and 75. We then plotted other-cause mortality by comorbidity count and cancer-specific mortality by tumor risk across subgroups aged <60, 60-70, and >70 years at diagnosis. We then compared the risk of cancer-specific mortality among men treated aggressively and conservatively across comorbidity groups. RESULTS Fourteen-year cumulative other-cause mortality was 24%, 33%, 46%, and 57% for men with comorbidity counts 0, 1, 2, and 3+, respectively. With each decade increase in age, the subhazard of other-cause mortality associated with comorbidity count doubled; in men with 3+ comorbidities, subhazard ratios (95%CI) for ages 65 and 75 (vs. 55) were 2.0 (1.6?2.5) and 4.0 (2.7?6.1). In men with 3+ comorbidities, ten-year other-cause mortality rates were 26%, 40%, and 71% for those aged ≤60, 61?74, and ≥75 at diagnosis, respectively (Figure). While men with zero or one comorbidity who were managed conservatively had 2.4 (95% CI 1.6?3.5) and 2.2-fold (95% CI 1.5?3.3) increases in the subhazard of cancer mortality compared with men treated aggressively, men with two or more comorbidities did not have a significant increase in prostate cancer mortality. CONCLUSIONS Older men with multiple major comorbidities are at high risk of other-cause mortality within ten years of diagnosis. Such men should consider this information when deciding between conservative management and aggressive treatment for low- or intermediate-risk prostate cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e24 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy J. Daskivich Los Angeles, CA More articles by this author Kang-Hsien Fan Nashville, TN More articles by this author Tatsuki Koyama Nashville, TN More articles by this author Peter C. Albertsen Farmington, CT More articles by this author Michael Goodman Atlanta, GA More articles by this author Ann S. Hamilton Los Angeles, CA More articles by this author Richard M. Hoffman Albuquerque, NM More articles by this author Janet L. Stanford Seattle, WA More articles by this author Antoinette M. Stroup Salt Lake City, UT More articles by this author Mark S. Litwin Los Angeles, CA More articles by this author David F. Penson Nashville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2023803153 title "58 AGE, COMORBIDITY, AND RISK OF OTHER-CAUSE MORTALITY: FOURTEEN-YEAR RESULTS FROM THE PROSTATE CANCER OUTCOMES STUDY (PCOS)" @default.
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