Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients

Jae Won Park, Dong Hoon Koh, Won Sik Jang, Joo Yong Lee, Kang Su Cho, Won Sik Ham, Koon Ho Rha, Woo Hee Jung, Sung Joon Hong, Young Deuk Choi

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4 Citations (Scopus)

Abstract

Purpose Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). Materials and methods We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010. Very high-risk PC was defined according to National Comprehensive Cancer Network guidelines. Patients with incomplete medical records or who had received neoadjuvant therapy were excluded. Preoperative comorbidity was evaluated by the ACCI, and the prognostic efficacy of the ACCI was analyzed using univariable and multivariable Cox regression, competing risk regression model and Kaplan-Meier curves. Results Our final analysis included 228 men with a median age of 66 years (interquartile range 62–71) and median prostate specific antigen of 10.7 ng/mL. There were 41 (18%) patients with an ACCI score >3 and 88 (38.6%) patients with a biopsy Gleason score >8. Preoperative evaluation revealed that 159 patients (69.7%) had a non-organ confined tumor (T3). Following RP, 8-year prostate cancer-specific survival (PCSS) and overall survival (OS) rates were 91.6% and 83.4%, respectively. Competing risk regression analysis revealed that ACCI was significantly associated with other-cause survival and OS (p<0.05). Conclusion The ACCI is an effective prognostic factor for other-cause survival and OS in very high-risk PC patients. RP should be considered carefully for patients with an ACCI score >3.

Original languageEnglish
Article numbere0199365
JournalPloS one
Volume13
Issue number6
DOIs
Publication statusPublished - 2018 Jun

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prostatic neoplasms
Prostatectomy
Comorbidity
Prostatic Neoplasms
Biopsy
Prostate-Specific Antigen
Regression analysis
Medical Records
Survival
Tumors
prostate-specific antigen
neoplasms
Neoadjuvant Therapy
comorbidity
Neoplasm Grading
biopsy
Neoplasms
regression analysis
Survival Rate
survival rate

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Park, Jae Won ; Koh, Dong Hoon ; Jang, Won Sik ; Lee, Joo Yong ; Cho, Kang Su ; Ham, Won Sik ; Rha, Koon Ho ; Jung, Woo Hee ; Hong, Sung Joon ; Choi, Young Deuk. / Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients. In: PloS one. 2018 ; Vol. 13, No. 6.
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title = "Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients",
abstract = "Purpose Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). Materials and methods We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010. Very high-risk PC was defined according to National Comprehensive Cancer Network guidelines. Patients with incomplete medical records or who had received neoadjuvant therapy were excluded. Preoperative comorbidity was evaluated by the ACCI, and the prognostic efficacy of the ACCI was analyzed using univariable and multivariable Cox regression, competing risk regression model and Kaplan-Meier curves. Results Our final analysis included 228 men with a median age of 66 years (interquartile range 62–71) and median prostate specific antigen of 10.7 ng/mL. There were 41 (18{\%}) patients with an ACCI score >3 and 88 (38.6{\%}) patients with a biopsy Gleason score >8. Preoperative evaluation revealed that 159 patients (69.7{\%}) had a non-organ confined tumor (T3). Following RP, 8-year prostate cancer-specific survival (PCSS) and overall survival (OS) rates were 91.6{\%} and 83.4{\%}, respectively. Competing risk regression analysis revealed that ACCI was significantly associated with other-cause survival and OS (p<0.05). Conclusion The ACCI is an effective prognostic factor for other-cause survival and OS in very high-risk PC patients. RP should be considered carefully for patients with an ACCI score >3.",
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Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients. / Park, Jae Won; Koh, Dong Hoon; Jang, Won Sik; Lee, Joo Yong; Cho, Kang Su; Ham, Won Sik; Rha, Koon Ho; Jung, Woo Hee; Hong, Sung Joon; Choi, Young Deuk.

In: PloS one, Vol. 13, No. 6, e0199365, 06.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients

AU - Park, Jae Won

AU - Koh, Dong Hoon

AU - Jang, Won Sik

AU - Lee, Joo Yong

AU - Cho, Kang Su

AU - Ham, Won Sik

AU - Rha, Koon Ho

AU - Jung, Woo Hee

AU - Hong, Sung Joon

AU - Choi, Young Deuk

PY - 2018/6

Y1 - 2018/6

N2 - Purpose Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). Materials and methods We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010. Very high-risk PC was defined according to National Comprehensive Cancer Network guidelines. Patients with incomplete medical records or who had received neoadjuvant therapy were excluded. Preoperative comorbidity was evaluated by the ACCI, and the prognostic efficacy of the ACCI was analyzed using univariable and multivariable Cox regression, competing risk regression model and Kaplan-Meier curves. Results Our final analysis included 228 men with a median age of 66 years (interquartile range 62–71) and median prostate specific antigen of 10.7 ng/mL. There were 41 (18%) patients with an ACCI score >3 and 88 (38.6%) patients with a biopsy Gleason score >8. Preoperative evaluation revealed that 159 patients (69.7%) had a non-organ confined tumor (T3). Following RP, 8-year prostate cancer-specific survival (PCSS) and overall survival (OS) rates were 91.6% and 83.4%, respectively. Competing risk regression analysis revealed that ACCI was significantly associated with other-cause survival and OS (p<0.05). Conclusion The ACCI is an effective prognostic factor for other-cause survival and OS in very high-risk PC patients. RP should be considered carefully for patients with an ACCI score >3.

AB - Purpose Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). Materials and methods We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010. Very high-risk PC was defined according to National Comprehensive Cancer Network guidelines. Patients with incomplete medical records or who had received neoadjuvant therapy were excluded. Preoperative comorbidity was evaluated by the ACCI, and the prognostic efficacy of the ACCI was analyzed using univariable and multivariable Cox regression, competing risk regression model and Kaplan-Meier curves. Results Our final analysis included 228 men with a median age of 66 years (interquartile range 62–71) and median prostate specific antigen of 10.7 ng/mL. There were 41 (18%) patients with an ACCI score >3 and 88 (38.6%) patients with a biopsy Gleason score >8. Preoperative evaluation revealed that 159 patients (69.7%) had a non-organ confined tumor (T3). Following RP, 8-year prostate cancer-specific survival (PCSS) and overall survival (OS) rates were 91.6% and 83.4%, respectively. Competing risk regression analysis revealed that ACCI was significantly associated with other-cause survival and OS (p<0.05). Conclusion The ACCI is an effective prognostic factor for other-cause survival and OS in very high-risk PC patients. RP should be considered carefully for patients with an ACCI score >3.

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