We investigated the influence of age and co-morbidity on treatment, the occurrence of serious non-urological complications of treatment and prognosis for prostate cancer patients diagnosed and treated in community hospitals. Additional information from a random sample of 505 prostate cancer patients (aged 40 years or older) from the Eindhoven Cancer Registry diagnosed between 1995 and 1999 was collected. In all, 43% of the prostate cancer patients aged 40-69 years and 64% of those aged 70 or older suffered from one or more serious concomitant disease that barely affected primary treatment choice. However, compared to patients without co-morbidity, patients with cardiovascular diseases underwent radical prostatectomy less often (P=0.01). In all, 38% of the patients undergoing radical prostatectomy suffered from complications during the first year after diagnosis versus about 20% of those receiving radiotherapy. The number of complications did not seem to be affected by co-morbidity. After adjustment for age, stage, grade, prostate-specific antigen level and treatment, the cumulative risk of death was almost two times higher for patients with two or more concomitant diseases than for patients without co-morbidity. After adjustment for age, prostate cancer patients with co-morbidity were not treated differently, did not suffer from more complications but had a worse prognosis, compared to those without co-morbidity.

Co-morbidity, Complications, Elderly, Prognosis, Treatment
dx.doi.org/10.1038/sj.pcan.4500868, hdl.handle.net/1765/67147
Prostate Cancer and Prostatic Diseases
Erasmus MC: University Medical Center Rotterdam

Houterman, S, Janssen-Heijnen, M.L.G, Verheij, C.D.G.W, Kil, P.J.M, van den Berg, H.A, & Coebergh, J.W.W. (2006). Greater influence of age than co-morbidity on primary treatment and complications of prostate cancer patients: An in-depth population-based study. Prostate Cancer and Prostatic Diseases, 9(2), 179–184. doi:10.1038/sj.pcan.4500868