Cause of Mortality after Radical Prostatectomy and the Impact of Comorbidity in Men with Prostate Cancer: A Multi-institutional Study in Korea
Cancer Research and Treatment 2020³â 52±Ç 4È£ p.1242 ~ p.1250
¹Ú»çÇö(Pak Sa-Hyun) - National Cancer Center Department of Urology
À¯´Þ»ê(You Dal-San) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
Á¤Àΰ©(Jeong In-Gab) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
À̵¿Àº(Lee Dong-Eun) - National Cancer Center Research Institute Biostatistics Collaboration Team
±è¼ºÇÑ(Kim Sung-Han) - National Cancer Center Department of Urology
Á¤À翵(Joung Jae-Young) - National Cancer Center Department of Urology
ÀÌ°Çö(Lee Kang-Hyun) - National Cancer Center Department of Urology
È«ÁØÇõ(Hong Jun-Hyuk) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
±èû¼ö(Kim Choung-Soo) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
¾ÈÇÑÁ¾(Ahn Han-Jong) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
Abstract
Purpose: This study aimed to examine the causes of death in Korean patients who underwent radical prostatectomy for prostate cancer and investigate the relationship between comorbidity and mortality.
Materials and Methods: We conducted a retrospective multicenter cohort study including 4,064 consecutive patients who had prostate cancer and underwent radical prostatectomy between January 1998 and June 2013. The primary endpoint of this study was all-cause mortality, and the secondary endpoints were cancer-specific mortality (CSM) and other-cause mortality (OCM). Charlson comorbidity index (CCI) was calculated to assess the comorbidities of each patient.
Results: Of 4,064 patients, 446 (11.0%) died during follow-up. The cause of death was prostate cancer in 132 patients (29.6%), other cancers in 121 patients (27.1%), and vascular disease in 57 patients (12.8%) in our cohort. The overall 10-year CSM rate was lower than the OCM rate (4.6% vs. 10.5%). The 10-year CSM rate was lower than the OCM rate in low- to intermediate-risk group patients (1.2% vs. 10.6%), whereas they were similar in high-risk group patients (11.8% vs. 10.1%). In the multivariable analysis, CCI was independently associated with all-cause mortality after radical prostatectomy, regardless of age and pathologic features.
Conclusion: Death from prostate cancer was rare in Korean men who underwent radical prostatectomy. Clinicians should be aware of the possibility of overtreatment of low-risk prostate cancer in men with significant comorbidity. Our findings may help to facilitate counseling and plan management in this patient group.
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Prostatic neoplasms, Survival, Comorbidity
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Mortality from prostate cancer was rare in Korean men who underwent radical prostatectomy. Physicians should be aware of the possibility of overtreatment for low-risk prostate cancer in men with significant comorbidity; Death from prostate cancer was rare in Korean men who underwent radical prostatectomy. Clinicians should be aware of the possibility of overtreatment of low-risk prostate cancer in men with significant comorbidity.