What does this research mean for the field?

Patients with ≥3 comorbidities have higher risks of 90-day general complications and genitourinary complications following radical prostatectomy for prostate cancer. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This research aims to determine how comorbidity levels affect complications after radical prostatectomy in men with prostate cancer.

January 24, 2026Cancer Control0 citationsOpen Access

Comorbidity Level and Risk of 90-day and 18-month Complications Among Patients Undergoing Radical Prostatectomy for Prostate Cancer in the Military Health System

YEYvonne L. EaglehouseHenry M. Jackson Foundation CDChristian Dide-AgossouHenry M. Jackson Foundation SDSarah DarmonHenry M. Jackson Foundation

Key Result

Patients with ≥3 comorbidities had higher risks of 90-day general complications (ARR = 1.88) and GU complications (ARR = 1.20) following radical prostatectomy for prostate cancer.

Key Points

This research aims to determine how comorbidity levels affect complications after radical prostatectomy in men with prostate cancer.
Identified a cohort of men with non-metastatic prostate adenocarcinoma from the MilCanEpi database.
Analyzed 90-day general and genitourinary complications, as well as hospital readmissions, using ICD-9 codes.
Used Poisson regression to calculate adjusted risk ratios for complications associated with different comorbidity levels.
Men with ≥3 comorbidities showed a significant increase in 90-day general complications (ARR = 1.88).
Greater risk of hospital readmission for patients with ≥3 comorbidities (ARR = 1.59).
At 18 months post-RP, increased risk of genitourinary complications observed in men with 1-2 (ARR = 1.19) and ≥3 comorbidities (ARR = 1.32).

Structured PICO

Does higher comorbidity level increase the risk of postoperative complications and readmissions in men undergoing radical prostatectomy for prostate cancer?

Population

5645 men with non-metastatic prostate adenocarcinoma from 2001-2014 who received radical prostatectomy (RP) within 1 year of diagnosis in the Military Health System (MHS), mean age 57.9 ± 7.7 years.

Intervention

Higher comorbidity levels (1-2 or ≥3 conditions based on Elixhauser Index)

Comparator

No comorbidity (0 conditions)

Outcome

90-day postoperative general and genitourinary (GU) complications and hospital readmissions; and 18-month postoperative GU complicationssafety

In men undergoing radical prostatectomy for prostate cancer, having a higher number of comorbidities significantly increases the risk of short- and long-term postoperative complications and readmissions.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction Prostate cancer is frequently diagnosed at ages when men may also have comorbidity. Access to care may influence both comorbidity management and cancer treatment and recovery. We examined the association between comorbidity and postoperative outcomes among men with prostate cancer in the universal access Military Health System (MHS). Methods We identified a cohort of men diagnosed with non-metastatic prostate adenocarcinoma from 2001-2014 who received radical prostatectomy (RP) within 1 year of diagnosis in the MilCanEpi database, which links the Department of War Cancer Registry and MHS Data Repository. We used ICD-9 diagnosis codes to capture 90-day postoperative general and genitourinary (GU) complications and hospital readmissions; and 18-month postoperative GU complications. Poisson regression estimated the adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) for the outcomes associated with comorbidity (0, 1-2, or ≥3) measured using the Elixhauser Index. Results The study included 5645 men with non-metastatic prostate cancer (mean age 57.9 ± 7.7 years) who received RP; 39.9% of patients had no comorbidity, 43.9% had 1-2 conditions, and 16.2% had ≥3 conditions. Patients with ≥3 comorbidities had statistically significant higher risks of 90-day general (ARR = 1.88, 95% CI = 1.34, 2.64) and GU (ARR = 1.20, 95% CI = 1.06, 1.36) complications and hospital readmission (ARR = 1.59, 95% CI = 1.12, 2.26) relative to men with no comorbidity. At 18-month post-RP, men with 1-2 comorbidities (ARR = 1.19, 95% CI = 1.05, 1.35) and ≥3 comorbidities (ARR = 1.32, 95% CI = 1.13, 1.55) had statistically significant higher risk of measured GU complications relative to men with no comorbidity. Conclusions In the MHS, higher comorbidity was associated with an increased risk of 30-day and 18-month complications and 90-day readmissions following RP for prostate cancer. This study identifies a need for risk management strategies to reduce complication rates among men with higher comorbidity levels diagnosed with prostate cancer and treated by RP.

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