Life expectancy estimation in older men using the prostate cancer comorbidity index in VA & SEER-Medicare cohorts.

Background Guidelines endorse specific life expectancy (LE) cutoffs for triage of definitive local treatment of prostate cancer, but the lack of validated, prostate cancer-specific LE prediction tools limits incorporation of LE in management decisions. Objective We sought to provide long-term LE pre...

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Publicado en:Age & Ageing Vol. 55; no. 4; pp. 1 - 10
Autores principales: Heard, John, Luu, Michael, Thomas, I-Chun, Leppert, John, Daskivich, Timothy
Formato: Artículo
Publicado: Oxford University Press / USA Apr2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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        10.1093/ageing/afag097
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        atl: Life expectancy estimation in older men using the prostate cancer comorbidity index in VA & SEER-Medicare cohorts.
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        au:
          Heard, John
          Luu, Michael
          Thomas, I-Chun
          Leppert, John
          Daskivich, Timothy
        affil:
          Cedars-Sinai Medical Center – Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA
          Cedars-Sinai Medical Center – Department of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, California, USA
          Stanford University – Department of Urology, Stanford University, Stanford, California, USA
      su:
        United States
        United States. Dept. of Veterans Affairs
        Life expectancy
        Medicare
        Age distribution
        Retrospective studies
        Aging
        Longevity
        Old age
        Medical protocols
        Pearson correlation (Statistics)
        Research funding
        Health insurance reimbursement
        Scientific observation
        Questionnaires
        Kruskal-Wallis Test
        Prostate tumors
        Severity of illness index
        Reporting of diseases
        Descriptive statistics
        Chi-squared test
        Multivariate analysis
        Longitudinal method
        Kaplan-Meier estimator
        Log-rank test
        Medical records
        Acquisition of data
        Cancer patient psychology
        Survival analysis (Biometry)
        Comparative studies
        Data analysis software
        Confidence intervals
        Comorbidity
        Nosology
        Overall survival
        Proportional hazards models
      sug:
        subj:
          Life expectancy
          Medicare
          Age distribution
          Retrospective studies
          Aging
          Longevity
          Old age
          United States
          United States. Dept. of Veterans Affairs
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Administration of Veterans' Affairs
          Medical protocols
          Pearson correlation (Statistics)
          Research funding
          Health insurance reimbursement
          Scientific observation
          Questionnaires
          Kruskal-Wallis Test
          Prostate tumors
          Severity of illness index
          Reporting of diseases
          Descriptive statistics
          Chi-squared test
          Multivariate analysis
          Longitudinal method
          Kaplan-Meier estimator
          Log-rank test
          Medical records
          Acquisition of data
          Cancer patient psychology
          Survival analysis (Biometry)
          Comparative studies
          Data analysis software
          Confidence intervals
          Comorbidity
          Nosology
          Overall survival
          Proportional hazards models
      keyword:
        ageing
        comorbidity
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        follow-up
        guidelines
        https://dx.doi.org/10.1093/ageing/afag097
        inLanguage:en
        international classification of diseases
        life expectancy
        longevity
        medicare
        mortality
        older adult
        older people
        prostate cancer
        prostate cancer stage i
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42043951/
        seer program
        survival
        ageing
        comorbidity
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        follow-up
        guidelines
        https://dx.doi.org/10.1093/ageing/afag097
        inLanguage:en
        international classification of diseases
        life expectancy
        longevity
        medicare
        mortality
        older adult
        older people
        prostate cancer
        prostate cancer stage i
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42043951/
        seer program
        survival
      ab: Background Guidelines endorse specific life expectancy (LE) cutoffs for triage of definitive local treatment of prostate cancer, but the lack of validated, prostate cancer-specific LE prediction tools limits incorporation of LE in management decisions. Objective We sought to provide long-term LE predictions in older men using the Prostate Cancer Comorbidity Index (PCCI), a validated tool for prediction of other-cause mortality based on age and presence and severity of major comorbidities, in nationally representative cohorts of US prostate cancer patients. Design, Setting, Subjects We performed an observational study of 916,890 men in the SEER-Medicare database and 243,928 men in the VA diagnosed with clinically localized prostate cancer between 2000 and 2019. Methods PCCI scores were calculated using ICD-9 and ICD-10 codes. Kaplan Meier and multivariable Cox proportional hazards analysis were used to measure overall survival by age-adjusted PCCI score groups. Results Median follow up was 11 years in both cohorts. In SEER-Medicare, men with PCCI scores of 1–2, 3–4, 5–6, 7–9, and 10+ had median estimated LE (95%CI) of 16.6 (16.5–16.7), 12.2 (12.1–12.2), 10.7 (10.6–10.7), 9.3 (9.2–9.3), and 5.4 (5.3–5.4) years, respectively. In the VA, men with the same PCCI scores had estimated median LE (95%CI) of 16.1 (16.0–16.3), 11.2 (11.1–11.4), 9.1 (8.9–9.2), 7.5 (7.4–7.7), and 5.2 (5.0–5.3) years, respectively. Conclusions The PCCI robustly predicts long-term longevity in SEER-Medicare and VA populations, with similar LE estimates in each. LE prediction tables with their accompanying variability estimates can help clinicians implement guidelines endorsed LE cutoffs for management of older men with prostate cancer.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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