Are we selecting the right patients for treatment of localized prostate cancer? Results of an actuarial analysis

Michael Koch, David A. Miller, Raymond Butler, Leo Lebos, David Collings, Joseph A. Smith

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives. To determine our accuracy in selecting patients with at least a 10-year life expectancy for aggressive treatment of localized prostate cancer. Methods. The medical records of 261 consecutive patients who underwent radical retropubic prostatectomy were submitted to the actuarial division of American General Life and Accident Insurance Company (AGLA) for estimation of life expectancy, excluding the diagnosis of prostate cancer. Survival curves were generated from predicted individual survivals. In patients with less than a 10-year life expectancy, AGLA provided us with the basis for assigning suboptimal survival rates. Results. The mean life expectancy for the group was 15.2 years. Two hundred ten men (80%) were projected to have a life expectancy of more than 10 years, including 27 of 55 (49%) and 4 of 8 (50%) men who were older than or equal to 70 and 75 years of age, respectively. Coronary artery disease and diabetes mellitus were the most common coexisting medical conditions that adversely affected risk as single disease entities. Conclusions. Although clinicians do not estimate life expectancy with the scientific exactitude of an actuary, the ability to assess the patient in person and assimilate pertinent medical information in a less rigid format yields similar results. Selection of men for definitive treatment of localized prostate cancer should be based on the inherent aggressiveness of the disease and the health of the individual and should not be limited by specific age cutoffs. Populations of men undergoing radical prostatectomy are younger and healthier than those in reported series of watchful waiting for prostate cancer.

Original languageEnglish (US)
Pages (from-to)197-202
Number of pages6
JournalUrology
Volume51
Issue number2
DOIs
StatePublished - Feb 1998
Externally publishedYes

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Actuarial Analysis
Patient Rights
Life Expectancy
Prostatic Neoplasms
Accident Insurance
Life Insurance
Prostatectomy
Therapeutics
Watchful Waiting
Survival
Medical Records
Coronary Artery Disease
Diabetes Mellitus
Survival Rate
Health

ASJC Scopus subject areas

  • Urology

Cite this

Are we selecting the right patients for treatment of localized prostate cancer? Results of an actuarial analysis. / Koch, Michael; Miller, David A.; Butler, Raymond; Lebos, Leo; Collings, David; Smith, Joseph A.

In: Urology, Vol. 51, No. 2, 02.1998, p. 197-202.

Research output: Contribution to journalArticle

Koch, Michael ; Miller, David A. ; Butler, Raymond ; Lebos, Leo ; Collings, David ; Smith, Joseph A. / Are we selecting the right patients for treatment of localized prostate cancer? Results of an actuarial analysis. In: Urology. 1998 ; Vol. 51, No. 2. pp. 197-202.
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