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- Chemotherapy and Radiotherapy
- Leukemia
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- Colon Cancer
- Breast Cancer
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Abstract
Citation: Clin Oncol. 2019;4(1):1638.DOI: 10.25107/2474-1663-v4-id1638
Charlson Comorbidity Index as a Predictor of Cancer Mortality Beyond 10 Years after Radical Prostatectomy
Moliere Nguile-Makao, Marc-André Allard, Isabelle Bairati, François Meyer, Karine Robitaille, Yves Fradet, Louis Lacombe, Frédéric Pouliot, Paul Toren, Thierry Duchesne and Vincent Fradet
Research Center of CHU de Québec-Laval University, Canada
Department of Surgery, Laval University, Canada
Department of Mathematics and Statistics, Laval University, Canada
*Correspondance to: Vincent Fradet
PDF Full Text Research Article | Open Access
Abstract:
Objectives: To validate the Charlson Comorbidity Index (CCI) in prostate cancer and to assess the impact of comorbidity on survival, both beyond 10 years following Radical Prostatectomy (RP). Subjects and Methods: A retrospective cohort study of 2,385 consecutive patients undergoing RP for localized prostate cancer between 1987 to 2007 was conducted at the Centre Hospitalier Universitaire (CHU) de Québec. We used CCI to quantify comorbidity at time of surgery. Death cause was determined from hospital records. The interaction CCI* time was tested with Cox model. Competing risk models with left truncation were used to estimate Sub-Hazard Risk (SHR) of Prostate-Cancer-Specific Mortality (PCSM) and Other Causes of Mortality (OCM) according to CCI. Results: Out of the 2,385 subjects, 647 (27.1%) were monitored over 10-years. There was no significant CCI* time interaction on the prediction of PCSM (P=0.122) or OCM (P=0.178). Beyond 10-years, comorbidity increased the risk of both OCM (CCI>1: adjusted SHR=2.2; CI 95% =1.2–4.1) and of PCSM (CCI=1: adjusted SHR=3.1; CI 95% =1.2–8.3). Conclusion: Baseline CCI is a good predictor of patient survival after RP for localized prostate cancer even after 10-years. A moderate increase in comorbidity (CCI=1) increases risk of PCSM. This highlights the clinical importance of evaluating and quantifying comorbidity in prostate cancer patients and may provide guidance to tailor long-term clinical follow-up.
Keywords:
Comorbidity; Charlson comorbidity index; Prostate cancer; Specific mortality; Competing Risks
Cite the Article:
Nguile-Makao M, Allard M-A, Bairati I, Meyer F, Fradet Y, Lacombe L, et al. Charlson Comorbidity Index as a Predictor of Cancer Mortality Beyond 10 Years after Radical Prostatectomy. Clin Oncol. 2019; 4: 1638 .