Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study

Timothy J Daskivich; Kang-Hsien Fan; Tatsuki Koyama; Peter C Albertsen; Michael Goodman; Ann S Hamilton; Richard M Hoffman; Janet L Stanford; Antoinette M Stroup; Mark S Litwin; David F Penson

doi:10.1016/j.urology.2014.07.003

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Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study

Journal article

Open access

Peer reviewed

Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study

Timothy J Daskivich, Kang-Hsien Fan, Tatsuki Koyama, Peter C Albertsen, Michael Goodman, Ann S Hamilton, Richard M Hoffman, Janet L Stanford, Antoinette M Stroup, Mark S Litwin, …

Urology (Ridgewood, N.J.), Vol.85(1), pp.92-100

01/2015

DOI: 10.1016/j.urology.2014.07.003

PMCID: PMC4275422

PMID: 25261048

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Abstract

To provide population-based estimates of other-cause mortality by age and comorbidity in men with prostate cancer for use at the point of care in shared decision making. We sampled 3183 men with nonmetastatic prostate cancer from the Prostate Cancer Outcomes Study, a US population-based prospective cohort. Survival analysis accounting for competing risks was used to provide predictions of other-cause and cancer-specific mortality by age, comorbidity, and tumor risk through 14 years of follow-up. Older men had a higher absolute risk of other-cause mortality associated with comorbidity. For men with comorbidity counts of 0, 1, 2, and 3+, cumulative incidence of other-cause mortality at 14 years was 9%, 18%, 30%, and 35% for those younger than 60 years; 26%, 26%, and 48%, and 52% for those aged 60-70 years; and 49%, 57%, 66%, and 74% for those older than 70 years. Prostate cancer mortality at 14 years was 5%, 8%, and 23% for men with low-, intermediate-, and high-risk disease. Competing risk pictograms for each age/comorbidity/tumor-risk pair provide visual characterization of these risks over time. Our survival tables may be used at the point of care as part of shared decision making. Men aged >60 years with multiple comorbidities have substantial risk of other-cause mortality within 15 years of diagnosis and should consider conservative management for low-risk disease, given its low incidence of cancer-specific mortality. Men with high-risk disease, regardless of age or comorbidity, are at greater risk for cancer mortality and may still be appropriate candidates for aggressive treatment.

Prostatic Neoplasms - pathology

Prognosis

Prospective Studies

Humans

Middle Aged

Male

Survival Rate

Cause of Death

Prostatic Neoplasms - mortality

Time Factors

Aged

Prostatic Neoplasms - complications

Neoplasm Staging

Details

Title: Subtitle: Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study
Creators: Timothy J Daskivich - Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA. Electronic address: Tdaskivich@ucla.edu
Kang-Hsien Fan - Department of Biostatistics, Vanderbilt University, Nashville, TN
Tatsuki Koyama - Department of Biostatistics, Vanderbilt University, Nashville, TN
Peter C Albertsen - Division of Urology, Department of Surgery, School of Medicine, University of Connecticut, Farmington, CT
Michael Goodman - Department of Epidemiology, Emory University, Atlanta, GA
Ann S Hamilton - Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
Richard M Hoffman - Department of Internal Medicine, University of New Mexico, Albuquerque, NM
Janet L Stanford - Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
Antoinette M Stroup - Department of Internal Medicine, University of Utah, Salt Lake City, UT
Mark S Litwin - Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA
David F Penson - Department of Urologic Surgery, Vanderbilt University, Nashville, TN; VA Tennessee Valley Geriatric Research, Education, and Clinical Centers, Nashville, TN
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.85(1), pp.92-100
DOI: 10.1016/j.urology.2014.07.003
PMID: 25261048
PMCID: PMC4275422
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Grant note: R01CA114524 / NCI NIH HHS R01 CA114524 / NCI NIH HHS
Language: English
Date published: 01/2015
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094391702771

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