The risk of prostate cancer (PCa)-specific mortality may not increase regardless of increasing comorbidities and the type of radical treatment received, according to a study published in the Journal of Clinical Oncology.1
Radical prostatectomy (RP) and radical radiotherapy (RT) are linked with a decreased PCa-specific mortality risk, though radical therapy is recommended only for patients who have a greater than 10-year life expectancy. The effect of treatment and comorbidities on PCa-specific mortality is not, however, fully understood.
For this observational study, researchers tracked the outcomes of 118,543 Swedish patients diagnosed with PCa over a median period of 8.3 years. Patients were stratified by various patient and tumor characteristics, and by whether they received RP, RT, or watchful waiting (WW).
The authors of the study initially observed that increased comorbidity increased the risk of death of PCa-specific and other-cause mortality.
But, after adjusting for patient and tumor characteristics, more comorbidities were associated with other-cause mortality only, not PCa-specific mortality.
Upon further adjustment for treatment type, the findings confirmed that a greater number of comorbidities had no effect on PCa-specific mortality, but did affect other-cause mortality.
The authors of the study concluded that “differences in oncologic outcome that were observed in population-based comparative effectiveness studies of PCa treatments do not seem to be a result of the varying distribution of comorbidity among treatment groups.”
- Rajan P, Sooriakumaran P, Nyberg T, et al. Effect of comorbidity on prostate cancer-specific mortality: a prospective observational study. J Clin Oncol. 2017 Sep 20. doi: 10.1200/JCO.2016.70.7794 [Epub ahead of print]