Mp68-20 Prediction of Life Expectancy Using the Prostate Cancer Comorbidity Index in a Large, Nationally Representative Cohort of Men With Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP68)1 May 2024MP68-20 PREDICTION OF LIFE EXPECTANCY USING THE PROSTATE CANCER COMORBIDITY INDEX IN A LARGE, NATIONALLY REPRESENTATIVE COHORT OF MEN WITH PROSTATE CANCER John Heard, Timothy J. Daskivich, I-Chun Thomoas, and John Leppert John HeardJohn Heard , Timothy J. DaskivichTimothy J. Daskivich , I-Chun ThomoasI-Chun Thomoas , and John LeppertJohn Leppert View All Author Informationhttps://doi.org/10.1097/01.JU.0001008744.60568.e8.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Accurate estimation of life expectancy (LE) remains a critical factor in triaging aggressive versus non-aggressive treatment for men with prostate cancer. Physicians have cited lack of robust information on variability of LE estimates as a barrier to use of LE data in treatment decision making. We sought to define LE estimates including data on variability using the Prostate Cancer Comorbidity Index (PCCI) in a large, nationally representative cohort of prostate cancer patients with long-term follow up. METHODS: We performed an observational study of 243,928 men with clinically localized prostate cancer in the Veterans Affairs Health System diagnosed between 2000 and 2019. Kaplan Meier and multivariable Cox proportional hazards analysis was used to measure overall mortality by the age-adjusted Prostate Cancer Comorbidity Index (PCCI) score, a validated LE prediction tool using a weighted score based on age and presence of major comorbidities. We calculated median LE as well as LE for the 25th and 75th percentile for subgroups of men with each PCCI score. RESULTS: Our analytic sample included 243,928 men with a median of 8.1 years of follow up among survivors. 25.2%, 35.4%, 18.8%, 9.0%, 6.8%, and 4.7% had PCCI scores of 0, 1–2, 3–4, 5–6, 7–9, and 10+. Kaplan-Meier analysis showed that life expectancy (25th, 75th) for each score group was not reached (13.8, NR), 16.1 years (9.8, NR), 11.2 years (6.3, 17.4), 9.1 years (4.8, 14.9), 7.5 years (3.7, 12.8), and 5.1 years (2.1, 9.4), respectively (Figure 1). Multivariable Cox analysis adjusting for tumor risk and race/ethnicity showed higher PCCI scores had successively higher risk of mortality: 1.79 (95% CI 1.75-1.83), 3.26 (95% CI 3.19), 3.33), 4.45 (95% CI 4.33-4.56), 5.74 (5.59-5.89), and 9.31 (95% CI 9.04-9.59) for PCCI 1–2, 3–4, 5–6, 7–9, and 10+ versus PCCI 0 respectively. CONCLUSIONS: The PCCI robustly predicts LE in men with early stage prostate cancer. These LE estimates, along with measures of their variability, can be used at the point of care to assist with treatment decision making. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1116 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information John Heard More articles by this author Timothy J. Daskivich More articles by this author I-Chun Thomoas More articles by this author John Leppert More articles by this author Expand All Advertisement PDF downloadLoading ...