Impact of comorbidity, Race, and marital status in men referred for prostate biopsy with PSA >20 ng/mL: A pilot study in high-risk patients

Zachary W A Klaassen, Roberto Muller, Qiang Li, Alexander J. Tatem, Sherita A King, Stephen J. Freedland, Rabii Hussein Madi, Martha Kennedy Terris, Kelvin A. Moses

Research output: Contribution to journalArticle

Abstract

Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazardsmodel and the association between Charlson Comorbidity Index (CCI) score and PCA diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years.Median CCI was 3 (IQR 2-4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95% CI 1.16, 17.54) PCA. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCA. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.

Original languageEnglish (US)
Article number362814
JournalISRN Urology
Volume2014
DOIs
StatePublished - Jan 1 2014

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Marital Status
Comorbidity
Prostate
Biopsy
Passive Cutaneous Anaphylaxis
Survival
African Americans
Prostatic Neoplasms
Logistic Models
Neoplasms

ASJC Scopus subject areas

  • Urology

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Impact of comorbidity, Race, and marital status in men referred for prostate biopsy with PSA >20 ng/mL : A pilot study in high-risk patients. / Klaassen, Zachary W A; Muller, Roberto; Li, Qiang; Tatem, Alexander J.; King, Sherita A; Freedland, Stephen J.; Madi, Rabii Hussein; Terris, Martha Kennedy; Moses, Kelvin A.

In: ISRN Urology, Vol. 2014, 362814, 01.01.2014.

Research output: Contribution to journalArticle

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abstract = "Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazardsmodel and the association between Charlson Comorbidity Index (CCI) score and PCA diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years.Median CCI was 3 (IQR 2-4), 69{\%} of patients were African American men, 56{\%} of patients were married, and 85{\%} of patients had a positive biopsy. CCI (HR 1.52, 95{\%} CI 1.19, 1.94), PSA (HR 1.62, 95{\%} CI 1.09, 2.42), and Gleason sum (HR 2.04, 95{\%} CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95{\%} CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95{\%} CI 1.16, 17.54) PCA. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCA. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.",
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T2 - A pilot study in high-risk patients

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AU - Muller, Roberto

AU - Li, Qiang

AU - Tatem, Alexander J.

AU - King, Sherita A

AU - Freedland, Stephen J.

AU - Madi, Rabii Hussein

AU - Terris, Martha Kennedy

AU - Moses, Kelvin A.

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N2 - Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazardsmodel and the association between Charlson Comorbidity Index (CCI) score and PCA diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years.Median CCI was 3 (IQR 2-4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95% CI 1.16, 17.54) PCA. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCA. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.

AB - Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazardsmodel and the association between Charlson Comorbidity Index (CCI) score and PCA diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years.Median CCI was 3 (IQR 2-4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95% CI 1.16, 17.54) PCA. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCA. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.

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