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Comorbidity, body mass index, and age and the risk of nonprostate‐cancer‐specific mortality after a postradiation prostate‐specific antigen recurrence
Author(s) -
Nguyen Paul L.,
Chen MingHui,
Beard Clair J.,
Suh W. Warren,
Choueiri Toni K.,
Efstathiou Jason A.,
Hoffman Karen E.,
Loffredo Marian,
Kantoff Philip W.,
D'Amico Anthony V.
Publication year - 2009
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.24818
Subject(s) - medicine , comorbidity , hazard ratio , prostate cancer , body mass index , proportional hazards model , cancer , confidence interval , prostate specific antigen , cumulative incidence , oncology , cohort
BACKGROUND: Some men with a postradiation therapy (RT) prostate‐specific antigen (PSA) recurrence will die of noncancer causes before developing metastases. Therefore, our ability to determine who would benefit from salvage hormonotherapy (HT) would be enhanced if an individual's risk of nonprostate‐cancer‐specific mortality were known. METHODS: Among 206 men with unfavorable‐risk localized prostate cancer initially randomized to RT+/−HT, 87 men who experienced PSA recurrence were studied. Fine and Gray's competing risks regression was used to assess whether body mass index (BMI) and the Adult Comorbidity Evaluation‐27 comorbidity level at randomization were associated with the risk of nonprostate‐cancer‐specific mortality after PSA recurrence, adjusting for age at recurrence. RESULTS: After a median postrecurrence follow‐up of 4.4 years, moderate/severe comorbidity (adjusted hazard ratio [HR] = 3.15; P = .02), BMI ≥ median (27.4 kg/m 2 ; adjusted HR=2.98; p=.04), and increasing age at recurrence (adjusted HR = 1.17; P = .03) were significantly associated with an increased risk of nonprostate‐cancer‐specific mortality. Five‐year cumulative incidence estimates of nonprostate‐cancer‐specific mortality were as follows: 0% (95% confidence interval [CI] [0,0]) for low‐risk patients (mild/no comorbidity and age