title: Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA. Electronic address: Tdaskivich@ucla.edu.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Daskivich
authors.affiliation: Department of Biostatistics, Vanderbilt University, Nashville, TN.
authors.forename: Kang-Hsien
authors.initials: KH
authors.lastname: Fan
authors.affiliation: Department of Biostatistics, Vanderbilt University, Nashville, TN.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Division of Urology, Department of Surgery, School of Medicine, University of Connecticut, Farmington, CT.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, GA.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.affiliation: Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, NM.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hoffman
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Stanford
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT.
authors.forename: Antoinette M
authors.initials: AM
authors.lastname: Stroup
authors.affiliation: 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.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
authors.affiliation: Department of Urologic Surgery, Vanderbilt University, Nashville, TN; VA Tennessee Valley Geriatric Research, Education, and Clinical Centers, Nashville, TN.
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
mesh_terms: D000368:Aged; D002423:Cause of Death; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate; D013997:Time Factors