AUA 2017: Predicting Competing Mortality in Patients Undergoing Radical Prostatectomy at an Age of 70 years or older

Boston, MA ( Given that the natural history of prostate cancer (PC) ranges from 7-12 years after diagnosis of metastases, competing comorbidities are important considerations to make during patient counseling and decision making. Within this context, Dr. Michael Froehner from the University Hospital – Dresden presents a predictive model of competing mortality in patients undergoing radical prostatectomy (RP) at an age of 70 years or older.

From 1992 through 2007, 2961 patients undergoing radical prostatectomy at an age of 70 years or older were retrospectively analyzed at an average follow-up time of 11.2 years. Proportional hazard models for associated with comorbidities at the time of surgery were compared individually to those less than 70 years old.

Previous reports describing PCSM and progression cite diabetes mellitus, chronic lung disease and cancers other than PC. In contrast, while these comorbidities indeed impact survival in younger men, they were not significant predictors of mortality for those undergoing RP at over 70 years old. Age, peripheral vascular disease, cerebrovascular disease, current smoking status, and ASA (American Society of Anesthesiologists) physical status class 3 were all independent predictors of competing mortality. Via totaling the number of significant comorbidities, the resulting score (1-5) was similarly predictive (as compared to the Akaike information criterion, Charlson score, and Lee mortality index).

Overall, the capability of estimating a patient’s risk for prostate cancer specific mortality (PCSM) versus overall mortality (OM) plays a significant role in treatment counseling and decision-making. By combining the five significant conditions associated with increased risk of PCSM in patients undergoing RP at 70 years or older, Dr. Froehner and colleagues present their index as a specific predictor of PCSM and OM.

Presented By: Michael Froehner, MD, University Hospital Dresden

Author(s): Michael Froehner, Rainer Kock, Matthias Hubler, Stefan Zastrow, Manfred Wirth

Affiliation: University Hospital Dresden

Written By: Linda Huynh (BS), an assistant research specialist from the University of California, Irvine, on behalf of

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA