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Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality.
J Natl Cancer Inst. 2007 Oct 17; 99(20):1516-24.JNCI

Abstract

BACKGROUND

We investigated whether androgen deprivation therapy (ADT) use is associated with an increased risk of death from cardiovascular causes in patients treated for localized prostate cancer.

METHODS

From the Cancer of the Prostate Strategic Urologic Research Endeavor database, data on 3262 patients treated with radical prostatectomy and 1630 patients treated with external beam radiation therapy, brachytherapy, or cryotherapy for localized prostate cancer were included in this analysis. Competing risks regression analyses were performed to assess whether use of ADT was associated with a shorter time to death from cardiovascular causes after controlling for age (as a continuous variable) and the presence of baseline cardiovascular disease risk factors. All tests for statistical significance were two-sided.

RESULTS

The median follow-up time was 3.8 years (range = 0.1-11.3 years). Among the 1015 patients who received ADT, the median duration of ADT use was 4.1 months (range = 1.0-32.9 months). In a competing risks regression analysis that controlled for age and risk factors for cardiovascular disease, both ADT use (adjusted hazard ratio [HR] = 2.6; 95% confidence interval [CI] = 1.4 to 4.7; P = .002) and age (adjusted HR = 1.07; 95% CI = 1.02 to 1.1; P = .003) were associated with statistically significantly increased risks of death from cardiovascular causes in patients treated with radical prostatectomy. Among patients 65 years or older treated with radical prostatectomy, the 5-year cumulative incidence of cardiovascular death was 5.5% (95% CI = 1.2% to 9.8%) in those who received ADT and 2.0% (95% CI = 1.1% to 3.0%) in those who did not. Among patients 65 years or older treated with external beam radiation therapy, brachytherapy, or cryotherapy, ADT use was associated with a higher cumulative incidence of death from cardiovascular causes, but the difference did not reach statistical significance.

CONCLUSIONS

The use of ADT appears to be associated with an increased risk of death from cardiovascular causes in patients undergoing radical prostatectomy for localized prostate cancer.

Authors+Show Affiliations

Harvard Radiation Oncology Program, Harvard Medical School, Boston, MA 02215, USA. hktsai@post.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17925537

Citation

Tsai, Henry K., et al. "Androgen Deprivation Therapy for Localized Prostate Cancer and the Risk of Cardiovascular Mortality." Journal of the National Cancer Institute, vol. 99, no. 20, 2007, pp. 1516-24.
Tsai HK, D'Amico AV, Sadetsky N, et al. Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst. 2007;99(20):1516-24.
Tsai, H. K., D'Amico, A. V., Sadetsky, N., Chen, M. H., & Carroll, P. R. (2007). Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. Journal of the National Cancer Institute, 99(20), 1516-24.
Tsai HK, et al. Androgen Deprivation Therapy for Localized Prostate Cancer and the Risk of Cardiovascular Mortality. J Natl Cancer Inst. 2007 Oct 17;99(20):1516-24. PubMed PMID: 17925537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. AU - Tsai,Henry K, AU - D'Amico,Anthony V, AU - Sadetsky,Natalia, AU - Chen,Ming-Hui, AU - Carroll,Peter R, Y1 - 2007/10/09/ PY - 2007/10/11/pubmed PY - 2007/10/31/medline PY - 2007/10/11/entrez SP - 1516 EP - 24 JF - Journal of the National Cancer Institute JO - J Natl Cancer Inst VL - 99 IS - 20 N2 - BACKGROUND: We investigated whether androgen deprivation therapy (ADT) use is associated with an increased risk of death from cardiovascular causes in patients treated for localized prostate cancer. METHODS: From the Cancer of the Prostate Strategic Urologic Research Endeavor database, data on 3262 patients treated with radical prostatectomy and 1630 patients treated with external beam radiation therapy, brachytherapy, or cryotherapy for localized prostate cancer were included in this analysis. Competing risks regression analyses were performed to assess whether use of ADT was associated with a shorter time to death from cardiovascular causes after controlling for age (as a continuous variable) and the presence of baseline cardiovascular disease risk factors. All tests for statistical significance were two-sided. RESULTS: The median follow-up time was 3.8 years (range = 0.1-11.3 years). Among the 1015 patients who received ADT, the median duration of ADT use was 4.1 months (range = 1.0-32.9 months). In a competing risks regression analysis that controlled for age and risk factors for cardiovascular disease, both ADT use (adjusted hazard ratio [HR] = 2.6; 95% confidence interval [CI] = 1.4 to 4.7; P = .002) and age (adjusted HR = 1.07; 95% CI = 1.02 to 1.1; P = .003) were associated with statistically significantly increased risks of death from cardiovascular causes in patients treated with radical prostatectomy. Among patients 65 years or older treated with radical prostatectomy, the 5-year cumulative incidence of cardiovascular death was 5.5% (95% CI = 1.2% to 9.8%) in those who received ADT and 2.0% (95% CI = 1.1% to 3.0%) in those who did not. Among patients 65 years or older treated with external beam radiation therapy, brachytherapy, or cryotherapy, ADT use was associated with a higher cumulative incidence of death from cardiovascular causes, but the difference did not reach statistical significance. CONCLUSIONS: The use of ADT appears to be associated with an increased risk of death from cardiovascular causes in patients undergoing radical prostatectomy for localized prostate cancer. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/17925537/Androgen_deprivation_therapy_for_localized_prostate_cancer_and_the_risk_of_cardiovascular_mortality_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djm168 DB - PRIME DP - Unbound Medicine ER -