Table of Contents
International Scholarly Research Notices
Volume 2014, Article ID 362814, 5 pages
Clinical Study

Impact of Comorbidity, Race, and Marital Status in Men Referred for Prostate Biopsy with PSA >20 ng/mL: A Pilot Study in High-Risk Patients

1Department of Surgery, Section of Urology, Charlie Norwood Veteran’s Administration Medical Center, Augusta, GA 30904, USA
2Department of Surgery, Section of Urology, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA
3Section of Surgery, Division of Urology, Durham Veteran’s Administration Medical Center, Durham, NC 27705, USA
4Departments of Surgery and Pathology, Division of Urology, Duke University School of Medicine, Durham, NC 27710, USA
5Department of Urologic Surgery, Vanderbilt University, A-1302 Medical Center North, Nashville, TN 37232, USA

Received 10 May 2014; Revised 14 June 2014; Accepted 15 June 2014; Published 24 August 2014

Academic Editor: R. Jeffrey Karnes

Copyright © 2014 Zachary Klaassen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazards model and the association between Charlson Comorbidity Index (CCI) score and PCa diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57–73) years. Median CCI was 3 (IQR 2–4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8–10 (OR 4.52, 95% CI 1.16, 17.54) PCa. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCa. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.