The Charlson comorbidity score: a superior comorbidity assessment tool for the prostate cancer multidisciplinary meeting.
BACKGROUND
Multidisciplinary team (MDT) meetings use precise prognostic factors to select treatment options for patients with prostate cancer. Comorbidity is judged subjectively. Recent publications favour the Charlson comorbidity score (CS) for the use in the management of prostate cancer. We assess the feasibility of using the CS by our MDT in planning the treatment of patients with prostate cancer.


METHODS
Patients from the histopathology database aged less than 75 years and with a diagnosis of localized prostate cancer between 1993 and 1995 were included in a notes audit. A second group consisted of patients recommended for curative treatment for localized prostate cancer by the local MDT in 2004. Data on comorbidity, prostatic malignancy and survival up to 10 years was collected. The prognostic accuracy of the CS was assessed for those patients offered radical treatment between 1993 and 1995.


RESULTS
Of 1043 patients initially assessed, 37 patients with localized prostate cancer were identified. Using Cox regression, we found the CS to be a statistically significant predictor of survival, following radical treatment for localized prostate cancer (P=0.005). Current practice in 2004 (56 patients) shows a mean (range) Charlson probability of 10-year survival for radical prostatectomy of 0.823 (0.592-0.923) and for radical radiotherapy of 0.653 (0.07-0.936).


CONCLUSIONS
Our results support the findings of recent research. We also found the CS easy to calculate and therefore feasible to use in our MDT setting. We propose the introduction of the Charlson score by prostate cancer MDTs to assess age and comorbidity.
Kastner
C
C
Department of Urology, St Richard's Hospital, Chichester, UK. ckastner@nhs.net
Armitage
J
J
Kimble
A
A
Rawal
J
J
Carter
P G
PG
Venn
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D002318:Cardiovascular Diseases / Q000150:complications; D015897:Comorbidity; D048909:Diabetes Complications / Q000175:diagnosis; D018572:Disease-Free Survival; D005240:Feasibility Studies; D006801:Humans; D033183:Interdisciplinary Communication; D052177:Kidney Diseases, Cystic / Q000150:complications; D008107:Liver Diseases / Q000150:complications; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012107:Research Design; D016019:Survival Analysis