Prostate Cancer: Localized: Surgical Therapy VIPD51-03 PREDICTING COMPETING MORTALITY IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY AT AN AGE OF 70 YEARS OR OLDER
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INTRODUCTION AND OBJECTIVES
Estimating the risk of competing mortality is of importance in tailoring optimal individual management strategies in patients with early prostate cancer. Patients selected for radical prostatectomy at an age of 70 years or older, a stricter selection for good risks may influence the prognostic significance of individual risk factors for competing mortality. No generally accepted tool is available in order to predict competing mortality in in this particular population.
METHODS
Using proportional hazard models for the subdistribution of competing risks according to Fine and Gray, we studied 2961 consecutive patients treated at our institution between 1992 and 2007 in order to determine which parameters predict competing mortality in patients selected for radical prostatectomy at an age of 70 years or older and compared the prognostic impact of individual parameters with that in their younger counterparts. The mean follow-up was 11.2 years.
RESULTS
Three common diseases (diabetes mellitus, chronic lung disease and other cancer) which predicted competing mortality in younger men were no predictors of competing mortality in men selected for radical prostatectomy at an age of 70 years or older (hazard ratios, HRs, lower than 1). Beside age (HR per year 1.08, p=0.0255), peripheral vascular disease (HR 2.33, p=0.0195), cerebrovascular disease (HR 2.23, p=0.0242), American Society of Anesthesiologists (ASA) physical status class 3 (HR 2.19,
CONCLUSIONS
Conclusions: Combining these five conditions in a score might provide a superior comorbidity measure in patients undergoing radical prostatectomy at an age of 70 years or older.
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