Overtreatment of men with low-risk prostate cancer and significant comorbidity

Abstract

CancerVolume 117, Issue 20 p. 4805-4805 CorrespondenceFree Access Overtreatment of men with low-risk prostate cancer and significant comorbidity First published: 08 April 2011 https://doi.org/10.1002/cncr.26131AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In a recently published interesting article,1 Daskivich et al stated that severe comorbidity, defined as a Charlson score of ≥3,2 should be considered a contraindication to aggressive treatment in men with low-risk prostate cancer. In light of these data, we analyzed our radical prostatectomy series of 2205 men with a mean age of 64.2 years treated between 1992 and 2005 with a mean follow-up of 7.9 years. We identified 139 patients with an unadjusted Charlson score of ≥3. Among them, the 10-year cumulative competing mortality rate was 27% (95% confidence interval, 16%-38%). This figure is substantially lower than the 70% rate reported by Daskivich et al1 and suggests that a Charlson score of ≥3 is not generally a contraindication to curative treatment in men with low-risk prostate cancer. Men who are considered otherwise suitable for radical prostatectomy could benefit from curative treatment despite having a Charlson score of ≥3. A careful consideration of the clinical setting is required when comorbidity classifications are evaluated in men with early stage prostate cancer. Using such classifications in populations containing severely impaired patients without initial filtering according to suitability for curative treatment is most likely not appropriate. REFERENCES 1 Daskivich TJ, Chamie K, Kwan L, et al. Overtreatment of men with low-risk prostate cancer and significant comorbidity. Cancer. [published online ahead of print November 29, 2010.] 2 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40: 373- 383. Volume117, Issue2015 October 2011Pages 4805-4805 ReferencesRelatedInformation