Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients
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 pro...
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| creator | 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 |
| description | 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).
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.
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 (p3. |
| doi_str_mv | 10.1371/journal.pone.0199365 |
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| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2062794354</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A543719971</galeid><doaj_id>oai_doaj_org_article_fb565ff04973494eb9c8d013e4a3241c</doaj_id><sourcerecordid>A543719971</sourcerecordid><originalsourceid>FETCH-LOGICAL-c758t-abd0ddc31dcd3f16fc568a1a93755cb846406c6b927707550af64e97570e03553</originalsourceid><addsrcrecordid>eNqNk22L1DAQx4so3nn6DUQDguiLXZOmSZs3wrL4sHBw4NPbMM1DN2vbrEl63H4HP7RZb--4lXshoaTM_OY_nelMUTwneE5oTd5t_BRG6OdbP5o5JkJQzh4Up0TQcsZLTB_eeT8pnsS4wZjRhvPHxUkpRFk1jJwWvxedmYHeTDEZjZZrCH30I1r6wYfWaZd2aDVqc4UgIkDb4LvRx-QUsqCSD8jmJ4B2Cvq9NyZIJjuGHfJTUn4wEXmLLk3YobXr1rPg4s9bECkYlQloC8mZMcWnxSMLfTTPDvdZ8f3jh2_Lz7Pzi0-r5eJ8pmrWpBm0GmutKNFKU0u4VYw3QEDQmjHVNhWvMFe8FWVd42zCYHllRM1qbDBljJ4VL691t72P8tDIKEvMy1pUlFWZWF0T2sNGboMbIOykByf_GnzoJITcht5I2zLOrMWVqGklKtMK1WhMqKmAlhVRWev9IdvUDkarXGmA_kj02DO6tez8peSY4JKLLPDmIBD8r8nEJAcXlel7GI2f9t_N6iZX2jQZffUPen91B6qDXIAbrc951V5ULrK7zsNUk0zN76Hy0WZwKk-dddl-FPD2KCAzyVylDqYY5errl_9nL34cs6_vsGsDfVpH30_J-TEeg9U1qPKAxWDsbZMJlvuluemG3C-NPCxNDntx9wfdBt1sCf0DgY0T4w</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2062794354</pqid></control><display><type>article</type><title>Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>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</creator><contributor>Ahmad, Aamir</contributor><creatorcontrib>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 ; Ahmad, Aamir</creatorcontrib><description>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).
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.
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).
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0199365</identifier><identifier>PMID: 29924851</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Age Factors ; Aged ; Analysis ; Biology and Life Sciences ; Biopsy ; Cancer ; Cancer surgery ; Cancer therapies ; Care and treatment ; Comorbidity ; Disease ; Disease-Free Survival ; Health risks ; Hospitals ; Humans ; Kaplan-Meier Estimate ; Male ; Medical prognosis ; Medical records ; Medical tests ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Patient outcomes ; Patients ; Physical Sciences ; Population ; Prognosis ; Proportional Hazards Models ; Prostate ; Prostate cancer ; Prostatectomy ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - surgery ; Radiation therapy ; Regression Analysis ; Regression models ; Research and Analysis Methods ; Risk analysis ; Risk Factors ; Studies ; Survival ; Treatment Outcome ; Urological surgery ; Urology</subject><ispartof>PloS one, 2018-06, Vol.13 (6), p.e0199365-e0199365</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Park et al 2018 Park et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-abd0ddc31dcd3f16fc568a1a93755cb846406c6b927707550af64e97570e03553</citedby><cites>FETCH-LOGICAL-c758t-abd0ddc31dcd3f16fc568a1a93755cb846406c6b927707550af64e97570e03553</cites><orcidid>0000-0002-8545-5797</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010269/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010269/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29924851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ahmad, Aamir</contributor><creatorcontrib>Park, Jae Won</creatorcontrib><creatorcontrib>Koh, Dong Hoon</creatorcontrib><creatorcontrib>Jang, Won Sik</creatorcontrib><creatorcontrib>Lee, Joo Yong</creatorcontrib><creatorcontrib>Cho, Kang Su</creatorcontrib><creatorcontrib>Ham, Won Sik</creatorcontrib><creatorcontrib>Rha, Koon Ho</creatorcontrib><creatorcontrib>Jung, Woo Hee</creatorcontrib><creatorcontrib>Hong, Sung Joon</creatorcontrib><creatorcontrib>Choi, Young Deuk</creatorcontrib><title>Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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).
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.
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).
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.</description><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Cancer surgery</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Comorbidity</subject><subject>Disease</subject><subject>Disease-Free Survival</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medical tests</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Population</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prostate</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Radiation therapy</subject><subject>Regression Analysis</subject><subject>Regression models</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Urological surgery</subject><subject>Urology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk22L1DAQx4so3nn6DUQDguiLXZOmSZs3wrL4sHBw4NPbMM1DN2vbrEl63H4HP7RZb--4lXshoaTM_OY_nelMUTwneE5oTd5t_BRG6OdbP5o5JkJQzh4Up0TQcsZLTB_eeT8pnsS4wZjRhvPHxUkpRFk1jJwWvxedmYHeTDEZjZZrCH30I1r6wYfWaZd2aDVqc4UgIkDb4LvRx-QUsqCSD8jmJ4B2Cvq9NyZIJjuGHfJTUn4wEXmLLk3YobXr1rPg4s9bECkYlQloC8mZMcWnxSMLfTTPDvdZ8f3jh2_Lz7Pzi0-r5eJ8pmrWpBm0GmutKNFKU0u4VYw3QEDQmjHVNhWvMFe8FWVd42zCYHllRM1qbDBljJ4VL691t72P8tDIKEvMy1pUlFWZWF0T2sNGboMbIOykByf_GnzoJITcht5I2zLOrMWVqGklKtMK1WhMqKmAlhVRWev9IdvUDkarXGmA_kj02DO6tez8peSY4JKLLPDmIBD8r8nEJAcXlel7GI2f9t_N6iZX2jQZffUPen91B6qDXIAbrc951V5ULrK7zsNUk0zN76Hy0WZwKk-dddl-FPD2KCAzyVylDqYY5errl_9nL34cs6_vsGsDfVpH30_J-TEeg9U1qPKAxWDsbZMJlvuluemG3C-NPCxNDntx9wfdBt1sCf0DgY0T4w</recordid><startdate>20180620</startdate><enddate>20180620</enddate><creator>Park, 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Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-abd0ddc31dcd3f16fc568a1a93755cb846406c6b927707550af64e97570e03553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Cancer surgery</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Comorbidity</topic><topic>Disease</topic><topic>Disease-Free Survival</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medical tests</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Population</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prostate</topic><topic>Prostate cancer</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Radiation therapy</topic><topic>Regression Analysis</topic><topic>Regression models</topic><topic>Research and Analysis Methods</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Studies</topic><topic>Survival</topic><topic>Treatment Outcome</topic><topic>Urological 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Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jae Won</au><au>Koh, Dong Hoon</au><au>Jang, Won Sik</au><au>Lee, Joo Yong</au><au>Cho, Kang Su</au><au>Ham, Won Sik</au><au>Rha, Koon Ho</au><au>Jung, Woo Hee</au><au>Hong, Sung Joon</au><au>Choi, Young Deuk</au><au>Ahmad, Aamir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-06-20</date><risdate>2018</risdate><volume>13</volume><issue>6</issue><spage>e0199365</spage><epage>e0199365</epage><pages>e0199365-e0199365</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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).
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.
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).
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29924851</pmid><doi>10.1371/journal.pone.0199365</doi><tpages>e0199365</tpages><orcidid>https://orcid.org/0000-0002-8545-5797</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2018-06, Vol.13 (6), p.e0199365-e0199365 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Age Factors Aged Analysis Biology and Life Sciences Biopsy Cancer Cancer surgery Cancer therapies Care and treatment Comorbidity Disease Disease-Free Survival Health risks Hospitals Humans Kaplan-Meier Estimate Male Medical prognosis Medical records Medical tests Medicine Medicine and Health Sciences Middle Aged Mortality Multivariate Analysis Patient outcomes Patients Physical Sciences Population Prognosis Proportional Hazards Models Prostate Prostate cancer Prostatectomy Prostatic Neoplasms - diagnosis Prostatic Neoplasms - surgery Radiation therapy Regression Analysis Regression models Research and Analysis Methods Risk analysis Risk Factors Studies Survival Treatment Outcome Urological surgery Urology |
| title | Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T23%3A12%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Age-adjusted%20Charlson%20Comorbidity%20Index%20as%20a%20prognostic%20factor%20for%20radical%20prostatectomy%20outcomes%20of%20very%20high-risk%20prostate%20cancer%20patients&rft.jtitle=PloS%20one&rft.au=Park,%20Jae%20Won&rft.date=2018-06-20&rft.volume=13&rft.issue=6&rft.spage=e0199365&rft.epage=e0199365&rft.pages=e0199365-e0199365&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0199365&rft_dat=%3Cgale_plos_%3EA543719971%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2062794354&rft_id=info:pmid/29924851&rft_galeid=A543719971&rft_doaj_id=oai_doaj_org_article_fb565ff04973494eb9c8d013e4a3241c&rfr_iscdi=true |