[Age and comorbidity in early prostate cancer]

With increasing age the risk-benefit balance of immediate curative treatment of early prostate cancer worsens. While the advantage of immediate intervention becomes increasingly uncertain the probability of unfavourable functional outcomes increases with an adverse impact on the quality of life. Therefore, a careful selection is particularly important in elderly patients with prostate cancer. For this purpose comorbidity classifications may be used; however up to now, there is no consensus on the instruments to be preferred and on the way of application. When different patient populations or clinical settings are considered the survival probabilities may differ significantly between patients with apparently identical levels of comorbidity. Therefore, when comorbidity classifications are intended to be used during treatment decision-making, it should be checked whether and how they are applicable in the individual clinical situation.