AUA 2018: Association between Androgen-Deprivation Therapy and Non-Prostate Cancer Mortality among Men with Non-Metastatic Prostate Cancer

San Francisco, CA ( Androgen deprivation therapy (ADT) has been associated with cardiovascular risk factors and the development of cardiovascular disease in men with metastatic prostate cancer. The effect of ADT on non-prostate cancer mortality is unknown among patients with non-metastatic prostate cancer.  The authors performed a population-based, retrospective cohort study of men treated with surgery or radiotherapy for non-metastatic prostate cancer in Ontario, Canada from 2002-2009.

ADT exposure was operationalized as a time-varying binary and cumulative dose exposure. Primary and secondary outcomes were non-prostate cancer mortality and cardiovascular mortality, respectively. The Fine & Gray sub-distribution method with generalized estimating equations was used to calculate sub-distribution hazard ratios (sdHR), while accounting for competing risks. 

A total of 20,651 men treated for non-metastatic prostate cancer were analyzed. Median follow-up was 7.4 years. Androgen deprivation therapy was not significantly associated with non-prostate cancer mortality (sdHR 0.75, 95% CI 0.37-1.50) or cardiovascular mortality (sdHR 1.16, 95% CI 0.37-3.63) when operationalized as a binary time-varying exposure (Table below). Similar results were obtained when ADT was examined as cumulative dose exposure. 

The authors conclude that Androgen deprivation therapy is not associated with non-prostate cancer mortality or cardiovascular mortality in a large, population-based cohort of men with localized prostate cancer treated by surgery or radiation therapy. 

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Presented By: Christopher Wallis, Toronto, Canada

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre Twitter: @GoldbergHanan at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA