Level of education and mortality after radical prostatectomy

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Michael Froehner - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • Rainer Koch - , Universitätsklinikum Carl Gustav Carus Dresden, Institut für Medizinische Informatik und Biometrie (Autor:in)
  • Stefan Propping - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • Dorothea Liebeheim - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • Matthias Hübler - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Anästhesiologie und Intensivtherapie (Autor:in)
  • Gustavo B. Baretton - , Institut für Pathologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Oliver W. Hakenberg - , Universität Rostock (Autor:in)
  • Manfred P. Wirth - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)

Abstract

Estimating the risk of competing mortality is of importance in men with early prostate cancer to choose the most appropriate way of management and to avoid over-or under-treatment. In this study, we investigated the impact of the level of education in this context. The study sample consisted of 2630 patients with complete data on level of education (college, university degree, master craftsmen, comparable profession, or others), histopathological tumor stage (organ confined or extracapsular), lymph node status (negative or positive), and prostatectomy specimen Gleason score (<7, 7, or 8-10) who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing, and second cancer-related mortalities were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. A higher level of education was independently associated with decreased overall mortality after radical prostatectomy (hazard ratio [HR]: 0.75, 95% confidence interval [95% CI]: 0.62-0.91, P = 0.0037). The mortality difference was attributable to decreased second cancer mortality (HR: 0.59, 95% CI: 0.40-0.85, P = 0.0052) and noncancer mortality (HR: 0.73, 95% CI: 0.55-0.98, P = 0.0345) but not to differences in prostate cancer-specific mortality (HR: 1.16, 95% CI: 0.79-1.69, P = 0.4536 in the full model). In conclusion, the level of education might serve as an independent prognostic parameter supplementary to age, comorbidity, and smoking status to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.

Details

OriginalspracheEnglisch
Seiten (von - bis)173-177
Seitenumfang5
FachzeitschriftAsian Journal of Andrology
Jahrgang19
Ausgabenummer2
PublikationsstatusVeröffentlicht - 2017
Peer-Review-StatusJa

Externe IDs

PubMed 28051039

Schlagworte

Ziele für nachhaltige Entwicklung

ASJC Scopus Sachgebiete

Schlagwörter

  • Comorbidity, Competing risk analysis, Level of education, Life expectancy, Mortality, Proportional hazards model, Prostate cancer, Radical prostatectomy, Smoking, Socioeconomic status