MUC-1 gene is associated with prostate cancer death: a 20-year follow-up of a population-based study in Sweden

Abstract Purpose Statins’ cholesterol-lowering efficacy is well-known. Recent epidemiological studies have found that inhibition of cholesterol synthesis may have beneficial effects on prostate cancer (PCa) patients, especially patients treated with androgen deprivation therapy (ADT). We evaluated statins’ effect on prostate cancer prognosis among patients treated with ADT. Materials and methods Our study population consisted of 8253 PCa patients detected among the study population of the Finnish randomized study of screening for prostate cancer. These were limited to 4428 men who initiated ADT during the follow-up. Cox proportional regression model adjusted for tumor clinical characteristics and comorbidities was used to estimate hazard ratios for risk of PSA relapse after ADT initiation and prostate cancer death. Results During the median follow-up of 6.3 years after the ADT initiation, there were 834 PCa deaths and 1565 PSA relapses in a study cohort. Statin use after ADT was associated with a decreased risk of PSA relapse (HR 0.73, 95% CI 0.65–0.82) and prostate cancer death (HR 0.82; 95% CI 0.69–0.96). In contrast, statin use defined with a one-year lag (HR 0.89, 95% CI 0.76–1.04), statin use before ADT initiation (HR 1.12, 95% CI 0.96–1.31), and use in the first year on ADT (HR 1.02, 95% CI 0.85–1.24) were not associated with prostate cancer death, without dose dependency. Conclusion Statin use after initiation of ADT, but not before, was associated with improved prostate cancer prognosis.

Download Full-text

Impact of putative chemopreventative agents on prostate cancer diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.40 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 40-40

Author(s):

Hanan Goldberg ◽

Faizan Moshin ◽

Zachary William Abraham Klaassen ◽

Thenappan Chandrasekar ◽

Christopher Wallis ◽

...

Keyword(s):

Prostate Cancer ◽

Cox Regression ◽

Large Population ◽

Multivariable Analysis ◽

Population Based ◽

Cumulative Exposure ◽

Population Based Study ◽

Diagnosis Rate ◽

The Impact

40 Background: Prostate cancer (PC) is the most common non-cutaneous cancer in Canadian men and the third most common cause of cancer death in Canada. Several studies have shown that use of commonly prescribed medications, including those used for diabetes and hypercholesterolemia, is associated with improved survival in various malignancies, including PC. There has not been any large population-based study, examining the effects of these and other commonly prescribed medications, on the rate of PC diagnosis, over a 20 years follow-up period. Methods: A retrospective population-based study using data from the institute of clinical evaluative sciences, including all male patients aged 65 and above in Ontario who have had a negative first prostate biopsy between 1994 and 2016. We assessed the impact of commonly prescribed medications on PC diagnosis. The medications included Statins (hydrophilic and hydrophobic), diabetes drugs (metformin, insulins, sulfonylureas, and thizolidinedions), proton pump inhibitors, 5 alpha reductase inhibitors, and alpha blockers. Time dependent Cox regression proportional hazards models were performed determine predictors of PC diagnosis. Medication exposure was time varying and modeled as “ever” vs. “never” use or as cumulative exposure for 6 months of usage. A priori variables included in the model included age, ADG comorbidity score, rurality index, index year, and all medications. Results: A total of 51,415 men were analyzed over a mean (SD) follow-up time of 8.06 (5.44) years. Overall, 10,466 patients (20.4%) were diagnosed with PC, 16,726 (32.5%) had died, and 1,460 (2.8%) patients died of PC. On multivariable analysis increasing age and rurality index were associated with higher PC diagnosis rate, while a more recent index year, and usage of hydrophilic statins was associated with a lower diagnosis rate in both “ever” vs. “never” and cumulative models (HR 0.832, 95% CI 0.732-0.946, p = 0.005, HR 0.973 95% CI 0.951-0.995, p = 0.016, respectively). Conclusions: Hydrophilic statins are associated with a clinically significant lower PC diagnosis. To our knowledge this is the first study demonstrating a clear advantage of one group of statins (hydrophilic) over another (hydrophobic) in PC prevention.

Download Full-text

Risk of prostate cancer death in long-term users of warfarin: a population-based case–control study

Cancer Causes & Control ◽

10.1007/s10552-013-0185-1 ◽

2013 ◽

Vol 24 (6) ◽

pp. 1079-1085 ◽

Cited By ~ 10

Author(s):

V. Tagalakis ◽

H. Tamim ◽

M. Blostein ◽

J. A. Hanley ◽

S. R. Kahn

Keyword(s):

Prostate Cancer ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Cancer Death ◽

Prostate Cancer Death ◽

Control Study

Download Full-text

Active surveillance of postradical prostatectomy biochemical recurrence: Long-term assessment of outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.5081 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 5081-5081

Author(s):

Tom Edward Ahlering ◽

Erica Huang ◽

Linda My Huynh ◽

Huang Wei Su

Keyword(s):

Prostate Cancer ◽

Active Surveillance ◽

Biochemical Recurrence ◽

Treatment Intervention ◽

Cancer Death ◽

Metastatic Progression ◽

Prostate Cancer Death ◽

Long Term Experience

5081 Background: Biochemical recurrence (BCR) following radical prostatectomy (RP) is an unreliable predictor of distant metastatic progression/prostate cancer death, resulting in potential complications & expenses of overtreatment. Little has been published on management decisions & outcomes of active surveillance (AS). We characterize our long term experience with AS following post-RP BCR without radiation/androgen deprivation therapy. Methods: From June 2002 - September 2019, 1865 men underwent RP. 406 experienced BCR; of these, 138 (34%) were observed without treatment intervention. BCR defined as PSA>0.2 ng/dl, x2. PSAs checked every 1-3 months and entered into a PSADT graph. Men were considered to be formally AS after 3+ years of increasing DT following RP. Men with decreasing DT were treated and censored. Results: The table depicts demographics of the AS patients; median follow-up was 7.3 years (IQR: 4.6-10.6) post-RP. Of patients on AS, average age was 63.7 +/- 7.2 years and 86%, 48%, 40%, 51% and 14% were GG 1 through 5, respectively. Current DT of AS patients averages 20 months, with 0% PCSM. Only 10% of patients with decreasing DT began treatment after average 4 years following BCR. Conclusions: Of 406 patients experiencing post-RP BCR, 34% of patients are effectively managed with AS, with 0% PCSM across all GG. Presently 69 (50%) AS men have been under observation for 7.3 to 18 years. This suggests that significant portion of patients display benign recurrence, characterized by increasing DT following BCR and can be managed safely with observation alone.[Table: see text]

Download Full-text

How Well Does the Gleason Score Predict Prostate Cancer Death? A 20-Year Followup of a Population Based Cohort in Sweden

The Journal of Urology ◽

10.1016/s0022-5347(05)00734-2 ◽

2006 ◽

Vol 175 (4) ◽

pp. 1337-1340 ◽

Cited By ~ 77

Author(s):

Ove Andrén ◽

Katja Fall ◽

Lennart Franzén ◽

Swen-Olof Andersson ◽

Jan-Erik Johansson ◽

...

Keyword(s):

Prostate Cancer ◽

Gleason Score ◽

Population Based ◽

Cancer Death ◽

Prostate Cancer Death

Download Full-text

Duration of Androgen Suppression Before Radiotherapy for Localized Prostate Cancer: Radiation Therapy Oncology Group Randomized Clinical Trial 9910

Journal of Clinical Oncology ◽

10.1200/jco.2014.58.0662 ◽

2015 ◽

Vol 33 (4) ◽

pp. 332-339 ◽

Cited By ~ 68

Author(s):

Thomas M. Pisansky ◽

Daniel Hunt ◽

Leonard G. Gomella ◽

Mahul B. Amin ◽

Alexander G. Balogh ◽

...

Keyword(s):

Prostate Cancer ◽

Survival Rates ◽

Intermediate Risk ◽

Cancer Death ◽

Disease Specific Survival ◽

Risk Prostate Cancer ◽

Prostate Cancer Death ◽

Androgen Suppression ◽

Disease Specific

Purpose To determine whether prolonged androgen suppression (AS) duration before radiotherapy improves survival and disease control in prostate cancer. Patients and Methods One thousand five hundred seventy-nine men with intermediate-risk prostate cancer were randomly assigned to 8 weeks of AS followed by radiotherapy with an additional 8 weeks of concurrent AS (16 weeks total) or to 28 weeks of AS followed by radiotherapy with an additional 8 weeks of AS (36 weeks total). The trial sought primarily to detect a 33% reduction in the hazard of prostate cancer death in the 28-week assignment. Time-to-event end points are reported for up to 10 years of follow-up. Results There were no between-group differences in baseline characteristics of 1,489 eligible patients with follow-up. For the 8- and 28-week assignments, 10-year disease-specific survival rates were 95% (95% CI, 93.3% to 97.0%) and 96% (95% CI, 94.6% to 98.0%; hazard ratio [HR], 0.81; P = .45), respectively, and 10-year overall survival rates were 66% (95% CI, 62.0% to 69.9%) and 67% (95% CI, 63.0% to 70.8%; HR, 0.95; P = .62), respectively. For the 8- and 28-week assignments, 10-year cumulative incidences of locoregional progression were 6% (95% CI, 4.3% to 8.0%) and 4% (95% CI, 2.5% to 5.7%; HR, 0.65; P = .07), respectively; 10-year distant metastasis cumulative incidences were 6% (95% CI, 4.0% to 7.7%) and 6% (95% CI, 4.0% to 7.6%; HR, 1.07; P = .80), respectively; and 10-year prostate-specific antigen–based recurrence cumulative incidences were 27% (95% CI, 23.1% to 29.8%) and 27% (95% CI, 23.4% to 30.3%; HR, 0.97; P = .77), respectively. Conclusion Extending AS duration from 8 weeks to 28 weeks before radiotherapy did not improve outcomes. A lower than expected prostate cancer death rate reduced ability to detect a between-group difference in disease-specific survival. The schedule of 8 weeks of AS before radiotherapy plus 8 weeks of AS during radiotherapy remains a standard of care in intermediate-risk prostate cancer.

Download Full-text

Combined impact of diet and lifestyle after diagnosis on risk of prostate cancer death.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.159 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 159-159 ◽

Cited By ~ 1

Author(s):

Stacey A. Kenfield

Keyword(s):

Prostate Cancer ◽

Processed Meat ◽

Cruciferous Vegetables ◽

Vigorous Activity ◽

Cancer Death ◽

Healthy Weight ◽

Total Diet ◽

Prostate Cancer Death ◽

Diet And Lifestyle

159 Background: Several lifestyle factors have been independently associated with prostate cancer progression and mortality, but little is known about their combined effect.Our objective wasto develop scores based on post-diagnostic diet and lifestyle behaviors for the prevention of prostate cancer death. Methods: We developed four scores (food-only: range 0-5; food & drinks: range 0-8; lifestyle-only: range 0-3; food, drinks & lifestyle: range 0-11) among 3,583 men in the Health Professionals Follow-Up Study diagnosed with non-metastatic prostate cancer in 1986-2008 with follow-up through 2012. Potential factors and their cut-points were based on the literature. One point was given for each factor: not currently smoking or quit ≥ 10 years ago, BMI < 30 kg/m2, ≥ 3 h/wk vigorous activity or ≥ 7 h/wk brisk walking, ≥ 1 serv/d cruciferous vegetables, ≥ 3 serv/wk nuts or oil-based dressings, ≥ 4 cups/d coffee, ≥ 7 serv/wk wine, < 2 serv/wk processed meat, 0 serv/wk poultry with skin or poultry sandwiches, and < 140 ug/d of supplemental selenium. We used multivariable Cox proportional hazards regression. Results: We observed 240 prostate cancer deaths during a median of 11 years follow-up. A 1-unit increase in each score was associated with a similar reduction in risk of prostate cancer death: food-only (HR = 0.71; 95%CI = 0.60,0.85); food & drinks (HR = 0.71; 95%CI = 0.61,0.82); lifestyle-only (HR = 0.72; 95%CI = 0.56,0.92); and total diet & lifestyle (HR = 0.71; 95%CI = 0.63,0.81). Men with 3 vs 0-1 points for the lifestyle-only score had a 51% decreased risk of prostate cancer death (95%CI = 0.28,0.83); men with ≥ 5 vs 0-2 points on the food & drinks score had a 73% decreased risk of prostate cancer death (95%CI = 0.14,0.51); and men with 4-7 and 8-11 vs 0-3 points for the total diet & lifestyle score had a 48% (95%CI = 0.32,0.84) and 75% (95%CI = 0.09,0.69) decreased risk of prostate cancer death. Conclusions: Adhering toa lifestyle characterized by frequent vigorous activity; not smoking; a healthy weight; a diet rich in cruciferous vegetables, healthy fats from vegetable sources, coffee, and wine and low in processed meat and poultry with skin; and avoiding excess supplemental selenium after prostate cancer diagnosis may lower risk of prostate cancer death.

Download Full-text