title: Validation of an Age-adjusted Prostate Cancer-Specific Comorbidity Index.
abstract: Estimating competing mortality is of paramount importance for prostate cancer screening candidates and men with early prostate cancer. An age-adjusted prostate cancer-specific comorbidity index (PCCI) was developed recently for this purpose in an unselected population of 1598 men. We validated this mortality index in a sample of 2961 patients who consecutively underwent radical prostatectomy between 1992 and 2007 at our institution. In patients with a PCCI of 0, 1-2, 3-4, 5-6, 7-9, and ≥10 who were selected for radical prostatectomy, the 10-yr competing mortality rates were 2%, 9%, 17%, 27%, 56%, and 0% (n=3), respectively, compared with 10%, 19%, 35%, 60%, 79%, and 99%, respectively, in the unselected development cohort. The PCCI is well suited to stratify patients with prostate cancer according to their risk of competing mortality. In candidates for radical prostatectomy, however, the 10-yr competing mortality rates are approximately half as high as in unselected patients with the same PCCI risk level.
  
  
  
  With stratification by the age-adjusted prostate cancer-specific comorbidity index, the 10-yr competing mortality rate in men selected for radical prostatectomy is approximately half as high as in unselected patients at the same level of comorbid risk.
authors.affiliation: Department of Urology, University Hospital "Carl Gustav Carus," Technische Universität Dresden, Dresden, Germany. Electronic address: Michael.Froehner@uniklinikum-dresden.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Froehner
authors.affiliation: Department of Medical Statistics and Biometry, University Hospital "Carl Gustav Carus," Technische Universität Dresden, Dresden, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Koch
authors.affiliation: Department of Anesthesiology, University Hospital "Carl Gustav Carus," Technische Universität Dresden, Dresden, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hübler
authors.affiliation: Department of Urology, University Hospital "Carl Gustav Carus," Technische Universität Dresden, Dresden, Germany.
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate
keywords: Bladder; Comorbidity; Competing risk analysis; Mortality; Prostate cancer; Radical prostatectomy; Urologic neoplasms