title: Charlson comorbidity index is an important prognostic factor for long-term survival outcomes in Korean men with prostate cancer after radical prostatectomy.
abstract: OBJECTIVE
  To analyze overall survival (OS), prostate cancer (PCa)-specific survival (PCaSS), and non-PCaSS according to the Charlson Comorbidity Index (CCI) after radical prostatectomy (RP) for PCa.
  
  
  METHODS
  Data from 336 patients who had RP for PCa between 1992 and 2005 were analyzed. Data included age, preoperative prostate-specific antigen (PSA), prostate volume, clinical stage, and pathologic stage. Pre-existing comorbidities were evaluated by the CCI, and patients were classified into two CCI score categories (0, ≥1).
  
  
  RESULTS
  The mean age of patients was 64.31±6.12 years. The median PSA value (interquartile range, IQR) was 11.30 (7.35 and 21.02) ng/mL with a median follow-up period (IQR) of 96.0 (85.0 and 121.0) months. The mean CCI was 0.28 (0-4). Five-year OS, PCaSS, and non-PCaSS were 91.7%, 96.3%, and 95.2%, respectively. Ten-year OS, PCaSS, and non-PCaSS were 81.9%, 92.1%, and 88.9%, respectively. The CCI had a significant influence on OS (p=0.022) and non-PCaSS (p=0.008), but not on PCaSS (p=0.681), by log-rank test. In multivariate Cox regression analysis, OS was independently associated with the CCI [hazard ratio (HR)=1.907, p=0.025] and Gleason score (HR=2.656, p<0.001). PCaSS was independently associated with pathologic N stage (HR=2.857, p=0.031), pathologic T stage (HR=3.775, p=0.041), and Gleason score (HR=4.308, p=0.001). Non-PCaSS had a significant association only with the CCI (HR=2.540, p=0.009).
  
  
  CONCLUSIONS
  The CCI was independently associated with both OS and non-PCaSS after RP, but the CCI had no impact on PCaSS. The comorbidities of a patient should be considered before selecting RP as a curative modality for PCa.
authors.affiliation: Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. kscho99@yuhs.ac.
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Dae Hun
authors.initials: DH
authors.lastname: Lee
authors.forename: Nam Hoon
authors.initials: NH
authors.lastname: Cho
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Hong
authors.forename: Seung Choul
authors.initials: SC
authors.lastname: Yang
authors.forename: Kang Su
authors.initials: KS
authors.lastname: Cho
mesh_terms: D000368:Aged; D015897:Comorbidity; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate
keywords: Prostatic neoplasms; comorbidity; survival