Satariano W A, Ragland K E, Van Den Eeden S K
Center for Family and Community Health, Division of Public Health Biology and Epidemiology, School of Public Health, University of California at Berkeley 94720, USA.
Cancer. 1998 Sep 15;83(6):1180-8. doi: 10.1002/(sici)1097-0142(19980915)83:6<1180::aid-cncr18>3.0.co;2-1.
Prostate carcinoma is one of the leading causes of death in men. Although the mortality rate is high, it still may underestimate the number of deaths associated with the disease. This study was conducted to compare causes of death among men previously diagnosed with prostate carcinoma and to examine the extent to which differences in cause of death (death from prostate carcinoma vs. death from other causes) varied by age, race, clinical factors, and comorbid conditions.
A review was conducted of the medical records of decedent members of the Kaiser Permanente Medical Care program who previously were diagnosed with prostate carcinoma between January 1980 and December 1984 (n=584). The review focused on demographic factors, symptoms, diagnostic tests, stage of disease, and treatment. Data on comorbidity were obtained from a computerized discharge summary. Logistic regression analysis was used to estimate odds ratios.
Approximately 54% of the decedent prostate carcinoma patients died of their prostate carcinoma. Decedents who were black, age < or = 65 years, diagnosed with more advanced disease stage, recipients of hormonal therapy, and whose death occurred > 6 months after diagnosis were more likely than others to die of prostate carcinoma. In contrast, the likelihood of dying of some other cause was associated with concurrent cardiovascular disease, after adjustment for the effects of race, age, and disease stage. There also were significant two-way age-race and age-time-to-death interactions.
The prognostic significance of cardiovascular disease in prostate carcinoma patients should be investigated in subsequent survival studies. A number of questions need to be addressed delineating the complex relations between coexisting diseases and their treatment.
前列腺癌是男性主要死因之一。尽管死亡率很高，但仍可能低估与该疾病相关的死亡人数。本研究旨在比较先前诊断为前列腺癌的男性的死因，并探讨死因差异（死于前列腺癌与死于其他原因）在年龄、种族、临床因素和合并症方面的变化程度。
对1980年1月至1984年12月期间曾被诊断为前列腺癌的凯撒永久医疗保健计划已故成员的病历进行了回顾（n = 584）。回顾重点关注人口统计学因素、症状、诊断测试、疾病分期和治疗。合并症数据来自计算机化出院小结。采用逻辑回归分析来估计比值比。
约54%的已故前列腺癌患者死于前列腺癌。黑人、年龄≤65岁、诊断为疾病晚期、接受激素治疗且死亡发生在诊断后6个月以上的死者比其他人更有可能死于前列腺癌。相比之下，在调整种族、年龄和疾病分期的影响后，死于其他原因的可能性与并发心血管疾病有关。年龄与种族、年龄与死亡时间之间也存在显著的双向交互作用。
在后续生存研究中应调查心血管疾病在前列腺癌患者中的预后意义。需要解决一些问题来阐明共存疾病及其治疗之间的复杂关系。
