2013
DOI: 10.7326/0003-4819-158-10-201305210-00005
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Effect of Age, Tumor Risk, and Comorbidity on Competing Risks for Survival in a U.S. Population–Based Cohort of Men With Prostate Cancer

Abstract: Background Accurate estimation of life expectancy is essential to offering appropriate care to men with early-stage prostate cancer, but mortality risks associated with comorbidity are poorly defined. Objective To determine the effect of age, comorbidity, and tumor risk on other-cause and prostate cancer–specific mortality in men with early-stage disease. Design Prospective cohort study. Setting A nationally representative, population-based cohort. Patients 3183 men with nonmetastatic prostate cancer a… Show more

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Cited by 165 publications
(123 citation statements)
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References 25 publications
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“…These men are unlikely to realize a prostate-cancer survival benefit with aggressive treatment. 37,38 Consequently, treatment recommendations are predicated on whether the patient can be expected to have a 10-year to 15-year life expectancy. 2,3 Although competing risks of mortality for men with localized prostate cancer are well recognized, 38,39 clinicians often poorly estimate life expectancy.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…These men are unlikely to realize a prostate-cancer survival benefit with aggressive treatment. 37,38 Consequently, treatment recommendations are predicated on whether the patient can be expected to have a 10-year to 15-year life expectancy. 2,3 Although competing risks of mortality for men with localized prostate cancer are well recognized, 38,39 clinicians often poorly estimate life expectancy.…”
Section: Discussionmentioning
confidence: 99%
“…37,38 Consequently, treatment recommendations are predicated on whether the patient can be expected to have a 10-year to 15-year life expectancy. 2,3 Although competing risks of mortality for men with localized prostate cancer are well recognized, 38,39 clinicians often poorly estimate life expectancy. 6,7 Adjusting life tables for comorbidity scores obtained from the SEER-Medicare database improves non-cancer survival estimates for recently diagnosed cancer patients.…”
Section: Discussionmentioning
confidence: 99%
“…Relatively higher survival rates were observed in younger patients (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) compared with older patients (65-74, 75+), particularly for sites including the stomach, lung, pancreas, B and CNS, blood (NHL) and cervix. Cancer of the oesophagus, female breast and bladder had higher survival in middle-aged groups (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)…”
Section: Resultsmentioning
confidence: 99%
“…24 We calculated the Charlson-Deyo comorbidity index and grouped patients into score categories of 0, 1, 2, ≥3. 25,26 Emergent surgery was defined as either non-elective surgery or emergent admission using clinical data. Using residency zip code, we linked to US Census data 27 to calculate residing neighborhood characteristics and distance from hospital.…”
Section: Outcomes and Covariatesmentioning
confidence: 99%