AUA 2018: ADT Increased the Risk of Pulmonary Embolism in Patients with Prostate Cancer - Taiwan National Health Insurance Research Database

San Francisco, CA ( Androgen deprivation therapy (ADT) is a standard treatment for men with metastatic prostate cancer. There are several known potential side-effects of ADT, such as weight gain, metabolic syndrome, hot flashes, and decreased bone density.  Jian-Hua Hong from National Taiwan University Hospital presented his group’s work looking at the association between ADT and pulmonary embolism (PE).

The group hypothesized that ADT may increase the rates of PE in men due to prior studies which showed that decreased testosterone levels reduced fibrinolytic activity. This suggests that ADT may lead to a hypercoagulable state in men on this treatment.  They performed a population-based retrospective study to assess if ADT led to increased rates of PE. They used a national database with a cohort 24,464 of men between January, 2000 and December 2008.  Patients were divided into those with prostate cancer who received ADT versus men with prostate cancer who had not received ADT.  They were appropriately age and comorbidity-matched to reduce bias. 

The group found that men who received ADT had a 1.4 times higher likelihood of developing a DVT or PE. This was found for both chemical and surgical castration. They additionally found that patients who had a longer duration of ADT had an increased risk of PE as compared to men on shorter courses.  They concluded that we must be cognizant of this increased risk of PE in men on ADT so that we can appropriately counsel patients regarding potential symptoms. 

Presented by: Jian-Hua Hong, Taipei, Taiwan
Co-Authors:  Yu-Chuan Lu, Chao-Yuan Huang, Yeong-Shiau Pu, Taipei, Taiwan

Written by: Brian Kadow, MD. Society of Urologic Oncology Fellow, Fox Chase Cancer Center, Philadelphia PA at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA
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