title: Low Other Cause Mortality Rates Reflect Good Patient Selection in Patients with Prostate Cancer Treated with Radical Prostatectomy.
abstract: Treatment decisions in patients with prostate cancer are affected by patient age regardless of higher life expectancy compared to the baseline population. Our aim was to quantify cancer specific and other cause mortality rates after radical prostatectomy.
  
  
  
  A total of 8,741 patients with prostate cancer underwent radical prostatectomy between 1992 and 2009 at a European center. Ten-year other cause and cancer specific mortality rates were determined by age and comorbidities, and age and Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) risk groups. Competing risk regression was used for risk factor analyses including clinical and pathological variables.
  
  
  
  Ten-year other cause mortality rates increased with patient age, including 4.8%, 9.8%, 13.6% and 16.5% in men younger than 60, 60 to 64, 65 to 69 and 70 years or older, respectively. Cancer specific mortality was the leading cause of death in CAPRA-S high risk cases regardless of age. On multivariate analyses age groups achieved independent predictor status for other cause mortality (ages 60 to 64 years HR 1.81, 95% CI 1.26-2.62, 65 to 69 years HR 2.48, 95% CI 1.73-3.56 and 70 years or greater HR 3.02, 95% CI 1.97-4.62) as well as Charlson comorbidity indexes 1 (HR 1.45, 95% CI 1.00-2.09) and 3 or greater (HR 3.99, 95% CI 1.57-10.1). Gleason score 3 + 4 and 4 + 3 or greater, pT3b stage, lymph node invasion and positive margin status achieved independent predictor status when the end point was cancer specific mortality. The CAPRA-S high risk constellation increased cancer specific mortality risk in multifold fashion (HR 26, 95% CI 16-56).
  
  
  
  In patients with the CAPRA-S high risk constellation the rate of cancer specific mortality increased in multifold fashion and contributed to most deaths regardless of patient age. Low other cause mortality rates in all age groups showed reasonable patient selection.
authors.affiliation: Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.
authors.forename: Katharina
authors.initials: K
authors.lastname: Boehm
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada; Unit of Urology, Division of Oncology, Urological Research Institute, National Institute for Research and Treatment Ospedale San Raffaele, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Larcher
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada; McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Quebec, Canada.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Tian
authors.affiliation: Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Mandel
authors.affiliation: Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Schiffmann
authors.affiliation: Department of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.affiliation: Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.affiliation: Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hartwig
authors.initials: H
authors.lastname: Huland
authors.affiliation: Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. Electronic address: d.tilki@uke.de.
authors.forename: Derya
authors.initials: D
authors.lastname: Tilki
mesh_terms: D000368:Aged; D002423:Cause of Death; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: age groups; mortality; prostate cancer; prostatic neoplasms; risk