Volume 15, Issue 5 (September 2013) 15, 667–671; doi:10.1038/aja.2013.25
Comorbidity and survival of patients selected for radical prostatectomy at an age of 75 years or older
Michael Froehner1, Rainer Koch2 and Manfred P Wirth1
1Departments of Urology, University Hospital ‘Carl Gustav Carus', Dresden University of Technology, Dresden D-01307, Germany 2Department of Medical Statistics and Biometry, University Hospital ‘Carl Gustav Carus’, Dresden University of Technology, Dresden D-01307, Germany
Correspondence: Dr M Froehner, (Michael.Froehner@uniklinikum-dresden.de)
Received 5 December 2012; Revised 27 January 2013; Accepted 5 March 2013 Advance online publication 3 June 2013
Abstract |
Radical prostatectomy in elderly patients is controversial. To identify very old candidates for radical prostatectomy with the highest probability of long-term survival, we studied 47 consecutive men who underwent radical prostatectomy between 1992 and 2005 at an age of 75 years or older. A heuristic approach was used to search for subgroups with particularly high long-term survival. Several two-sided comorbidity measures and combinations of these measures were investigated to find classifications best identifying healthy, long-living elderly candidates for radical prostatectomy. Four of the 25 two-sided comorbidity classifications or combinations reached the significance level with hazard ratios between 4.00 and 4.80. After 10 years, patients identified as healthy patients according to these comorbidity measurements had exhibited relative survival rates between 129% and 137% and overall survival rates between 86% and 95%, whereas those with comorbidities had exhibited relative survival rates of only 66%–84% and overall survival rates of 44%–58%. In conclusion, classifying comorbidity may identify a meaningful proportion of men selected for radical prostatectomy at an age of 75 years or older with an excellent long-term survival probability superseding that of the general population.
Keywords: comorbidity; old age; overall survival; prostate cancer; radical prostatectomy; relative survival
PDF |
PDF |
中文摘要 |
|
|
Browse: 1823 |
|