The influence of cardiovascular morbidity on the prognosis in prostate cancer. Experience from a 12-year nationwide Danish population-based cohort study
The influence of cardiovascular morbidity on the prognosis in prostate cancer. Experience from a 12-year nationwide Danish population-based cohort study
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DOI：
10.1186/1471-2407-11-519
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发表时间：
2011-12-15
期刊：
影响因子：
3.8
通讯作者：
Borre, Michael
中科院分区：
文献类型：
--
作者：
Jespersen, Christina G.;Norgaard, Mette;Borre, Michael
背景：确定既往存在的缺血性心脏病（IHD）和卒中对前列腺癌患者总生存率的影响。方法：我们对1997年至2008年在丹麦癌症登记处登记的前列腺癌患者进行了一项队列研究。我们在丹麦国家患者登记处确定了在前列腺癌诊断日期之前诊断为IHD或中风的患者。我们构建Kaplan-Meier曲线来分析死亡时间，并使用Cox回归来估计风险比（HRs），以比较先前存在的IHD或卒中状态的死亡率，调整年龄、分期、合并症和日历期。结果：30721例前列腺癌患者中，4276例（14%）既往存在IHD， 1331例（4%）既往存在卒中。未存在IHD或卒中患者的1年和5年粗生存率分别为85%和44%，存在IHD患者的粗生存率分别为81%和36%，存在卒中患者的粗生存率分别为78%和27%。与未存在IHD或卒中的患者相比，IHD患者的调整hr为1.05 (95% CI 1.00-1.10)，卒中患者的调整hr为1.20 （95% CI 1.12-1.30）。结论：先前存在的IHD对前列腺癌患者的死亡率影响很小，而先前存在中风的前列腺癌患者的总死亡率比没有IHD或中风的前列腺癌患者高20%。这些结果强调了区分各种合并症的重要性。
Background: To determine the impact of preexisting ischemic heart disease (IHD) and stroke on overall survival in prostate cancer patients.Methods: We conducted a cohort study of patients with incident prostate cancer registered in the Danish Cancer Registry from 1997 through 2008. We identified patients diagnosed with IHD or stroke prior to the date of prostate cancer diagnosis in the Danish National Patient Registry. We constructed Kaplan-Meier curves to analyze time to death and Cox regression was used to estimate hazard ratios (HRs) to compare mortality rates by preexisting IHD or stroke status, adjusting for age, stage, comorbidity, and calendar period.Results: Of 30,721 prostate cancer patients, 4,276 (14%) had preexisting IHD and 1,331 (4%) preexisting stroke. Crude 1- and 5-year survival rates were 85% and 44% in men without preexisting IHD or stroke, 81% and 36% in men with preexisting IHD, and 78% and 27% in men with preexisting stroke. Adjusted HRs were 1.05 (95% CI 1.00-1.10) for patients with IHD and 1.20 (95% CI 1.12-1.30) for patients with stroke compared with patients without preexisting IHD or stroke.Conclusions: Preexisting IHD had minimal impact on mortality in prostate cancer patients, whereas overall mortality was 20% higher in prostate cancer patients with preexisting stroke compared to those without IHD or stroke. These results highlight the importance of differentiating between various comorbidities.