Prevalence and survival prognosis of prostate cancer in patients with end-stage renal disease: a retrospective study based on the Korea national database (2003–2010)
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Sung Han Kim1,*, Jae Young Joung1,*, Yoon Seok Suh1, Young Ae Kim2, Jin Hyuk Hong2, Tong Sun Kuark3, Eun Sook Lee4 and Kang Hyun Lee1
1Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea
2Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
3Health Insurance Policy Research Institute, National Health Insurance Service, Seoul, Korea
4Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
*These authors have contributed equally to this work
Kang Hyun Lee, email: [email protected]
Keywords: prostate cancer, end-stage renal disease, transplantation, prostate-specific antigen, prognosis
Received: January 25, 2017 Accepted: May 10, 2017 Published: July 22, 2017
Objective: The study was aimed to evaluate the prevalence and prognosis of prostate cancer (PC) and end-stage renal disease (ESRD), determine the risk factors for overall survival (OS) and PC-specific survival (CSS), and evaluate differences in PC-related clinical therapeutic patterns between patients with and without PC-ESRD.
Methods: This observational population study, performed at the National Cancer Center and Cancer Research Institute in Korea, included patients with PC and ESRD from the nationwide Korean Health Insurance System and Korean Central Cancer Registry data. Five-year overall and cancer-specific survival. A joinpoint regression analysis was performed to predict incidence and mortality of PC. Survival was analyzed using Kaplan-Meir curves with log rank tests of patients with dialysis or transplantation.
Results: Of 3945 patients with PC-ESRD, 3.9% were on dialysis (N=152), 0.2% had kidney transplantation (N=10, D-TPL group); 3783 (95.9%) had neither dialysis nor transplantation (non-D-TPL ESRD group). There were 697 PC-specific deaths. The median respective OS, PC-specific survival, and 5-year survival rates in the non-ESRD, non-D-TPL ESRD, dialysis ESRD, and transplantation ESRD groups were significantly different (p<0.001). Presence of ESRD, age, body mass index, SEER stage, no treatment within 6 months after diagnosis, no surgery, chemotherapy, radiotherapy or hormonal therapy, non-adenocarcinoma pathology, and Charlson comorbidity index were independent risk factors for OS and CSS.
Conclusions: With a 10.1% nationwide prevalence of PC-ESRD, the presence of ESRD was a significant survival factor along with other significant clinicopathological factors.
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