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Current impact of age and comorbidity assessment on prostate cancer treatment choice and over/undertreatment risk

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Abstract

Purpose

We evaluated the influence of age and comorbidity (Charlson score assessment) on localized prostate cancer therapeutic management and the risk of prostate cancer over- and under-treatment.

Methods

Among the 2571 prostate cancer cases diagnosed in 2011, a subset of 633 patients was randomly selected from the prospectively accrued cohort of the Regional Cancer Registry, among the 17 participating institutions. Treatment distributions were examined for patients at each individual prostate cancer risk, age and comorbidity level and analyzed by multivariate logistic regression analysis.

Results

Treatments with curative intent were observed less often when age increased (p < 0.001). We found no impact of the Charlson score on the selection of a curative treatment [HR 0.89, 95 % CI (0.70–1.15)]. A 20 % overtreatment rate was reported in low-risk prostate cancer patients. For younger patients (65–75 years) with high comorbidity score, a 14 % overtreatment rate was observed. Conversely, a 16 % undertreatment rate was reported in older patients >75 years without any significant comorbidity.

Conclusion

A better consideration of comorbidities could significantly reduce overtreatment in patients <75 year and promote curative treatment in aggressive prostate cancer for older patients without any significant comorbidity.

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Authors and Affiliations

  1. University Hospital of Rangueil, Toulouse, France

    Pierre Lunardi, Mathieu Roumiguié, Michel Soulié, Jean Baptiste Beauval & Bernard Malavaud

  2. Urology Department, Saint Jean Languedoc Hospital, Toulouse, France

    Guillaume Ploussard

  3. National Cancer Registry, INSERM, Toulouse, France

    Pascale Grosclaude

Authors
  1. Pierre Lunardi
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  2. Guillaume Ploussard
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  3. Pascale Grosclaude
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  4. Mathieu Roumiguié
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  5. Michel Soulié
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  6. Jean Baptiste Beauval
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  7. Bernard Malavaud
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Corresponding author

Correspondence to Pierre Lunardi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Authors’ contribution

Lunardi P.: Data collection or management, Data analysis, Manuscript writing/editing, Ploussard G.: Content’s review, Grosclaude P.: Data analysis, Roumiguié M.: Protocol/project development, Soulié M.: Protocol/project development, Beauval JB.: Protocol/project development, Content’s review. Malavaud B.: Protocol/project development, Manuscript writing, Content’s review.

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Lunardi, P., Ploussard, G., Grosclaude, P. et al. Current impact of age and comorbidity assessment on prostate cancer treatment choice and over/undertreatment risk. World J Urol 35, 587–593 (2017). https://doi.org/10.1007/s00345-016-1900-9

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  • DOI: https://doi.org/10.1007/s00345-016-1900-9

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