Examining predictors of mortality in older patients treated with surgery

This study examined predictors of mortality risk in older prostate cancer patients treated with surgery. Authors reported that blood vessel disorders, severity of a whole-body disease, smoking status, and education level were significant predictors of mortality in older men treated with surgery.

Radical treatment options for prostate cancer, such as surgery, have previously not been recommended for older patients. Older men with longer life expectancies, however, may benefit from active treatment. Overall life expectancies are expected to continue to increase. Therefore, identifying risk factors that could impact the prognosis of prostate cancer is becoming increasingly important.

This study aimed to identify predictors of mortality risk in prostate cancer patients treated with surgery.

The records of 2,961 men treated with prostate surgery were analyzed. 543 of these men were aged 70 years or older. Based on their medical history and other factors, a model was constructed to predict mortality risk depending on age.

Peripheral vascular disease (a blood circulation disorder) increased mortality risk 2.04-fold for younger men and 2.33-fold for older men. Cerebrovascular disease (conditions that affect the supply of blood to the brain) was not a risk factor for younger men, but increased mortality risk 2.23-fold for older men. Being a current smoker increased mortality risk 2.06-fold for younger men and 2.18-fold for older men. Having a moderate-to-severe disease affecting the whole body increased mortality risk by 63% for younger men and 2.19-fold for older men. A low level of education increased mortality risk by 39% for younger men and 2.07-fold for older men.

Three common diseases (diabetes, chronic lung disease, and other cancers) significantly predicted mortality in younger men. However, these were not significant predictors of mortality in older men.

Authors reported that blood vessel disorders, severity of a whole-body disease, smoking status, and education level were significant predictors of mortality in older men treated with surgery.

Older patients included in this study were already selected for surgery with favorable risks. Therefore, results may not apply to all older prostate cancer patients.