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

San Francisco, CA (UroToday.com) 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
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