Medical androgen deprivation therapy and increased non-cancer mortality in non-metastatic prostate cancer patients aged ≥66 years.
Eur J Surg Oncol
; 41(11): 1529-39, 2015 Nov.
Article
en En
| MEDLINE
| ID: mdl-26210655
ABSTRACT
PURPOSE:
To examine the potential relationship between androgen deprivation therapy and other-cause mortality (OCM) in patients with prostate cancer treated with medical primary-androgen deprivation therapy, prostatectomy, or radiation.METHODS:
A total of 137,524 patients with non-metastatic PCa treated between 1995 and 2009 within the Surveillance Epidemiology and End Results Medicare-linked database were included. Cox-regression analysis tested the association of ADT with OCM. A 40-item comorbidity score was used for adjustment.RESULTS:
Overall, 9.3% of patients harbored stage III-IV disease, and 57.7% of patients received ADT. The mean duration of ADT exposure was 22.9 months (median 9.1; IQR 2.8-31.5). Mean and median follow-up were 66.9, and 60.4 months, respectively. At 10 years, overall-OCM rate was 36.5%; it was 30.6% in patients treated without ADT vs. 40.1% in patients treated with ADT (p < 0.001). In multivariable-analysis, ADT was associated with an increased risk of OCM (Hazard-ratio [HR] 1.11, 95% Confidence-interval [95% CI] 1.08-1.13). Patients with no comorbidity (10-year OCM excess risk 9%) were more subject to harm from ADT than patients with high comorbidity (10-year OCM excess risk 4.7%).CONCLUSIONS:
In patients with PCa, treatment with medical ADT may increase the risk of mortality due to causes other than PCa. Whether this is a simple association or a cause-effect relationship is unknown and warrants further study in prospective studies.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Prostatectomía
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Neoplasias de la Próstata
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Enfermedades Cardiovasculares
/
Sistema de Registros
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Medición de Riesgo
/
Antineoplásicos Hormonales
/
Antagonistas de Andrógenos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Eur J Surg Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2015
Tipo del documento:
Article