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Abstract: PO1860

Impact of ESKD on Overall and Cancer-Specific Mortality in Patients with Localized Prostate Cancer (PCa): A Retrospective Cohort Study of SEER-Medicare

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Author

  • Sarabu, Nagaraju, University Hospitals, Cleveland, Ohio, United States
Background

Our objective was to compare overall and PCa specific mortality between ESKD and non-ESKD patients with localized PCa.

Methods

Study participants were male patients, who were diagnosed with localized PCa between January 1st 2004 and September 30, 2015 (last day of International Classification of Diseases-9-Clinical Modification (ICD-9-CM) use) and were 40 years or older at the time of diagnosis. ESKD status, further stratified into dialysis and kidney transplant (KT) was determined using ICD-9-CM codes. Time to death from any cause was modeled using Cox regression and time to PCa specific death using Fine and Gray competing risk model.

Results

At a median follow up of 6.2 years, 3.5 years and 5.0 years for non-ESKD (N=186,482), dialysis (N=970) and KT (N=413), overall mortality rates were 1.8%, 8.5%, and 4.8% at 1-year, 7.7%, 31.5% and 13.5% at 3-years and 15.2%, 50.8% and 27.9% at 5-years respectively (P-Value: <0.001), Figure 1. In multivariate model, dialysis status was associated with 2.9 times higher hazard of death (HR: 2.62.93.1) and transplant status was associated with 2 times higher hazard of death (HR: 1.72.02.4) compared to non-ESKD group. Rates of PCa specific mortality were 0.4%, 1.1%, and 0.7% at 1-year, 1.6%, 3.1%, and 1.5% at 3-years and 3%, 4.8%, and 2.2% at 5-years for non-ESKD, dialysis, and transplant groups respectively (P-value: 0.04). In multivariate model, dialysis status and transplant status were associated with similar risks for PCa specific death to non-ESKD group, Figure 2.

Conclusion

ESKD patients have excess relative overall mortality but similar PCa specific mortality compared to non-ESKD patients with localized PCa.

Cumulative Incidence Curves

Hazard Ratios for Mortality