Impact of Hypertension on Early Renal Dysfunction in Japanese Prostate Cancer Patients Treated With Androgen Deprivation Therapy

2021 ◽  
Vol 1 (3) ◽  
pp. 179-183
Author(s):  
HIROSHI MASUDA ◽  
MASAHIRO SUGIURA ◽  
KYOKUSIN HOU ◽  
KAZUHIRO ARAKI ◽  
SATOKO KOJIMA ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Salt Intake ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Rate Of Change ◽  
Increased Risk

Background/Aim: Recently, it was reported that the use of androgen deprivation therapy (ADT) is significantly associated with an increased risk of acute kidney injury (AKI) in patients with newly diagnosed non-metastatic prostate cancer. This study aimed to investigate the incidence of early renal dysfunction in Japanese prostate cancer patients receiving ADT and the factors associated with it. Patients and Methods: A total of 135 patients who had been pathologically diagnosed with prostate cancer and had received ADT for at least 6 months were eligible for study inclusion. The estimated glomerular filtration rate (eGFR) before treatment, and at 1, 3, and 6 months of ADT were evaluated retrospectively. We assessed renal function using eGFR and investigated the rate of change in the eGFR (ΔeGFR) during ADT. Univariate and multivariate logistic analyses were carried out to identify clinical factors that were significantly associated with renal dysfunction after 6 months ADT. Results: A total of 110 cases were evaluated in this study. The incidence of renal dysfunction after 6 months ADT was 63% (69/110). The mean ΔeGFR after 1, 3, and 6 months of ADT were –0.6%, –3.1% and –1.7%, respectively (p<0.001). Multivariate analysis showed that renal dysfunction after 3 months of ADT and hypertension were independent risk factors for renal dysfunction after 6 months ADT. Conclusion: Renal dysfunction occurs from 1 month of ADT and hypertensive prostate cancer patients receiving ADT are at high risk of developing renal dysfunction, and that such patients should be treated very carefully. Therefore, patients that are started on ADT should undergo periodic prostate-specific antigen, renal function, and urinary salt intake examinations.

598: Increased Risk of Newly Diagnosed Comorbidities in Prostate Cancer Patients Treated with Androgen Deprivation Therapy

2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200 ◽  
Author(s):  
Andrea Gallina ◽  
Pierre I. Karakiewicz ◽  
Jochen Walz ◽  
Claudio Jeldres ◽  
Quoc-Dien Trinh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Increased Risk

Proportion of biochemically-recurrent prostate cancer patients with durable undetectable PSA after short-course androgen deprivation therapy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 207-207
Author(s):  
Daniel M. Lim ◽  
Roman Gulati ◽  
Serge Aleshin-Guendel ◽  
Heather H. Cheng ◽  
Agnes M. Gawne ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Initial Therapy ◽  
Androgen Deprivation ◽  
Clinical Value ◽  
Short Course ◽  
Increased Risk ◽  
The University ◽  
Trial Endpoint

207 Background: Optimal utilization of novel therapies for advanced prostate cancer is challenging without a validated surrogate efficacy endpoint. Ongoing trials are using durable undetectable prostate specific antigen (PSA) levels as a marker of efficacy. The proportion of patients and clinical relevance of those with a prolonged undetectable PSA after a short course of androgen deprivation therapy (ADT) is uncertain. Methods: The University of Washington Caisis database was queried for radical prostatectomy patients who received 6–12 months of ADT after biochemical recurrence (BCR), defined as PSA ≥ 0.2 ng/mL and no radiographically detectable metastasis. Proportions of patients with undetectable PSA 12 and 24 months after ending ADT were compared to a hypothesized 5% rate using exact binomial tests. Associations with patient and tumor characteristics were examined using logistic regression, and associations with risk of subsequent metastasis and death from any cause were evaluated by log-rank tests. Results: After ineligibility exclusions, data were abstracted from 93 patients. Proportions of patients with undetectable PSA 12 and 24 months after ending ADT were n=23/93 (24.7%; 95% CI 16.4–34.8%; P<0.001) and n=14/93 (15.1%; 95% CI 8.5–24.0%; P<0.001), respectively. Proportions of patients with undetectable PSA 12 and 24 months after testosterone recovery ≥ 50 ng/dL were n=16/65 (24.6%; 95% CI 14.8-36.9%) and n=10/65 (15.4%; 95% CI 7.6-26.5%), respectively. Being 1 year older at diagnosis was associated with an 11.5% (95% CI 3.1–21.9%; P=0.01) increase in the odds of having a detectable PSA after controlling for PSA at diagnosis, Gleason sum and time from initial therapy to BCR. Detectable PSA was associated with increased risk of metastasis (P=0.006) with marginal evidence of association with death from any cause (P=0.07). Conclusions: This single-institution retrospective analysis shows that it is not uncommon to have undetectable PSA 12 or 24 months after a short course of ADT. Additional analysis is needed to demonstrate the clinical value of this measure as a surrogate for prostate cancer outcomes and for consideration as a trial endpoint.

scholarly journals Efficacy and Prognostic Factors of Androgen Deprivation Therapy Combined with Radiation Therapy for Prostate Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Siping Zeng ◽  
Gangyun Guan ◽  
Qiuwei Qin ◽  
Huadong Xie ◽  
Yongyan Meng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Reference Group ◽  
Remission Rate ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Clinical Prognosis ◽  
Factors Affecting

Objective. To analyze the efficacy of androgen deprivation therapy (ADT) combined with radiation therapy (also known as radiotherapy) for prostate cancer. Methods. The clinical data of 94 prostate cancer patients treated in the Oncology Department of Xiangzhou People’s Hospital from January 2017 to January 2018 were retrospectively analyzed, and the patients were divided into the combined group and the reference group according to their admission order, with 47 cases each. The patients in the reference group only received the radiotherapy, and on this basis, those in the combined group accepted ADT, so as to evaluate the efficacy of different treatment methods by comparing the patients’ serum total prostate-specific antigen (T-PSA), vascular endothelial growth factor (VEGF), and other indicators and analyze the relevant factors affecting patients’ prognosis by Cox single-factor and multi-factor regression models. Results. Compared with the reference group after treatment, the patients in the combined group obtained significantly lower T-PSA and VEGF levels ( P < 0.001 ), significantly higher objective remission rate and disease control rate ( P < 0.05 ), and remarkably longer modified progression-free survival (mPFS) and overall survival (OS) ( P < 0.001 ), and after the multi-factor research, it was found that the Gleason score of 8–10, positive lymphatic metastasis, and single radiotherapy were the factors affecting the clinical prognosis of prostate cancer. Conclusion. Combining ADT with radiotherapy ensures a better survival benefit for prostate cancer patients and has a fairly well efficacy. Further study will be conducive to establishing a better solution for such patients.

scholarly journals Risk of ischemic stroke in patients with prostate cancer receiving androgen deprivation therapy in Taiwan

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kuang-Ming Liao ◽  
Yaw-Bin Huang ◽  
Chung-Yu Chen ◽  
Chen-Chun Kuo
Keyword(s):  
Prostate Cancer ◽  
Ischemic Stroke ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Increased Risk ◽  
Significant Difference ◽  
First Occurrence ◽  
Ischemic Stroke Risk ◽  
Primary Composite Outcome

Abstract Background Androgen deprivation therapy (ADT) in the treatment of prostate cancer may be associated with an increased risk of thromboembolic disease. The aim of our study was to investigate the association of ADT in the treatment of prostate cancer with ischemic stroke risk. Methods We identified individuals older than 20 years of age who were newly diagnosed with prostate cancer between January 1, 2005, and December 31, 2012. Patients who experienced ischemic stroke or transient ischemic stroke before the index date were excluded. Patients who received at least one prescription for ADT within 6 months were defined as the ADT user group. Patients who did not receive at least one prescription for ADT within 6 months were defined as the ADT nonuser group. The patients were followed until the first occurrence of one of the primary outcome measures (ischemic stroke or death) or until December 31, 2013. The primary composite outcome was the time to any cause of death or ischemic stroke. Results There was no significant difference in the primary composite outcomes in the prostate cancer patients between the ADT user and nonuser groups. Prostate cancer patients who received ADT had a higher mortality rate than those who were not treated with ADT, and the adjusted hazard ratio was 1.907 (95% confidence interval: 1.278–2.844; P = 0.0016) after adjusting for age, comorbidities and comedication use. Conclusion ADT in the treatment of prostate cancer may not be associated with an increased risk of ischemic stroke. The differences in thromboembolic effects in cardiovascular disease and ischemic stroke secondary to ADT should be further discussed and evaluated prospectively.

The risk of death from prostate cancer in men with Gleason Score 3+4 prostate cancer treated using brachytherapy with or without a short course of androgen deprivation therapy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 330-330
Author(s):  
David Dewei Yang ◽  
Ming-Hui Chen ◽  
Michelle H. Braccioforte ◽  
Brian Joseph Moran ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Risk Of Death ◽  
Short Course ◽  
Increased Risk ◽  
Adenocarcinoma Of The Prostate ◽  
Biopsy Gleason Score

330 Background: We evaluated whether the intermediate-risk factors of percentage of positive biopsies (PPB), clinical tumor category, and prostate-specific antigen (PSA) level, in addition to age, were associated with the risk of prostate cancer-specific mortality (PCSM) among men with Gleason 3+4 prostate cancer treated with brachytherapy (BT) alone or BT and a short course of androgen deprivation therapy (ADT). Methods: We conducted a prospective cohort study of 1920 consecutively treated men with Gleason 3+4 adenocarcinoma of the prostate who received BT or BT and a median of 4 months of ADT between 10/14/1997 and 5/28/2013. Separate multivariable Fine and Gray competing risks regression models among men treated with BT or BT and ADT were used to assess whether PPB, cT2b-T2c, and PSA of 10.1-20.0 ng/ml, in addition to age greater than the median of 70 years, were associated with the risk of PCSM after adjustment for comorbidity. Results: After a median follow-up of 7.8 years (interquartile range 5.2-10.4 years), 284 men (14.8%) had died, including 31 (10.9% of deaths) from PC of which 18 (58.1%) and 13 (41.9%) occurred in men treated with BT or BT and ADT, respectively. For men treated with BT alone, increasing PPB, PSA of 10.1-20.0 vs 4.0-10.0 ng/mL, and age >70 vs ≤70 years were significantly associated with an increased risk of PCSM (adjusted hazard ratio [AHR] 1.015 95% confidence interval [CI] 1.000-1.031, P=0.048; AHR 5.55, 95% CI 2.01-15.29, P<0.001; and AHR 3.66, 95% CI 1.16-11.56, P=0.03, respectively). The respective results for men treated with BT and ADT were AHR 1.009, 95% CI 0.987-1.031, P=0.44; AHR 4.17, 95% CI 1.29-13.50, P=0.02; and AHR 3.74, 95% CI 0.87-16.05, P=0.08. The clinical tumor category was not significantly associated with the risk of PCSM. Conclusions: Among men with biopsy Gleason score 3+4 PC, both age >70 years and PSA of 10.1-20.0 ng/ml were significantly associated with an increased risk of PCSM following BT, and adding 4 months of ADT may not be sufficient to mitigate this risk. Advanced imaging and targeted biopsy of suspicious areas should be considered to personalize treatment in order to minimize the risk of PCSM in these men.

scholarly journals Post-hoc analysis of changes in renal function of prostate cancer patients: Focus on androgen deprivation therapy

2020 ◽  
Author(s):  
Yoshiyuki Miyazawa ◽  
Yoshitaka Sekine ◽  
Seiji Arai ◽  
Daisuke Oka ◽  
Hiroshi Nakayama ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Renal Function ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Estimated Glomerular Filtration Rate ◽  
Androgen Deprivation ◽  
University Hospital ◽  
Post Hoc Analysis ◽  
Significant Difference ◽  
Post Hoc

Abstract Background To investigate the association between androgen deprivation therapy (ADT) and changes in the estimated glomerular filtration rate (eGFR) in male Japanese prostate cancer patients, based on post-hoc analysis of data from a previous prospective study.Methods From among 103 prostate cancer patients in whom renal function changes were tracked over 5 years, 88 were divided into a group who completed ADT within 3 years (short ADT group; n = 47) and a group who continued with ADT for more than 5 years (continuous ADT group; n = 41). We compared the groups in terms of the eGFR, calculated based on age and serum creatinine (mg/dL), before ADT initiation and every other year over the next 5 years. This study was approved by the Ethics Committee for Clinical Studies of Gunma University Hospital (Approval No: 8 − 5).Results The eGFR decreased by 4.91 and 2.89 ml/min in the short and continuous ATD groups, respectively, over the 5-year period following ADT initiation. The respective decreases in the eGFR were 0.98 and 0.58 ml/min/year. No significant difference in the eGFR was observed between the two groups at any measurement point.Conclusions ADT patients showed a decrease in the eGFR of 0.58–0.98 ml/min/y over a 5-year period, which is about twice as high as that of normal Japanese males. No significant difference in the eGFR by ADT duration was observed.

Does androgen deprivation therapy impair renal function in patients with prostate cancer?

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 323-323
Author(s):  
Koji Mitsuzuka ◽  
Atsushi Kyan ◽  
Tomonori Sato ◽  
Kazuhiko Orikasa ◽  
Minoru Miyazato ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Renal Function ◽  
Androgen Deprivation Therapy ◽  
Lean Mass ◽  
Specific Antigen ◽  
Psoas Muscle ◽  
Androgen Deprivation ◽  
Muscle Area ◽  
Impair Renal Function ◽  
Before And After

323 Background: While the adverse effects of androgen deprivation therapy (ADT) in patients with prostate cancer are generally well-known among physicians, it is not clear whether ADT affects renal function. Therefore, the goal of the present study was to assess changes in renal function in response to ADT for 1 year. Methods: Patients with prostate cancer who were hormone-naïve and scheduled to receive long-term ADT were recruited between 2011 and 2013. Body weight and blood testing, including lipid and glucose metabolism and renal function, were recorded every 3 months during 1 year of ADT. Estimated glomerular filtration rate (eGFR) was calculated based on baseline age throughout ADT. Computed tomography (CT) was performed to measure psoas muscle area before and after 1 year of ADT to evaluate the influence of a decrease in lean mass on renal function. ADT was limited to a luteinizing hormone-releasing hormone agonist with or without bicalutamide. Patients who had severe renal dysfunction (eGFR < 30 mL/min/m2) or who had disease progression during 1 year of ADT were excluded from analyses. Results: Of 217 registered patients, renal function data were available from 170 patients who completed 1 year of ADT. Mean changes in serum creatinine and eGFR were 1.3% and 0.2%, respectively. Prostate specific antigen, clinical stage, body mass index, total testosterone, hemoglobin A1c, creatinine, eGFR, and comorbidities (e.g., hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease) at baseline were not associated with a change in renal function. Age < 70 years at baseline was associated with an increase in eGFR in univariate and multivariate analyses (univariate: P = 0.01, multivariate: 95% confidence interval 1.13-4.87, P = 0.03). CT was performed in 72 patients before and after 1 year of ADT. The mean decrease in psoas muscle area was -8.4%. Decrease in psoas muscle area and increase of eGFR were more frequent in patients of age < 70 years than in those of age ≥ 70 years (psoas muscle: -10.2% vs. -7.5%, P = 0.05; eGFR: 6.4% vs. 0.2%, P = 0.03). Conclusions: ADT did not impair renal function in patients with prostate cancer. eGFR was more likely to increase in younger patients, but this increase may be due to a decrease in lean mass. Clinical trial information: UMIN000004709.

Early versus delayed initiation of salvage androgen deprivation therapy and the risk of prostate cancer-specific mortality.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 189-189
Author(s):  
Brandon Arvin Virgil Mahal ◽  
Ming-Hui Chen ◽  
Andrew A. Renshaw ◽  
Philip W. Kantoff ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Specific Antigen ◽  
Androgen Deprivation ◽  
Early Initiation ◽  
Study Cohort ◽  
Increased Risk ◽  
Specific Mortality ◽  
Salvage Androgen Deprivation Therapy

189 Background: We sought to ascertain whether there is an association between prostate cancer (PC)-specific mortality (PCSM) and salvage androgen deprivation therapy (ADT) timing amongst men with short versus long prostate-specific antigen doubling times (PSA-DT)s. Methods: The study cohort was selected from 206 men with localized unfavorable-risk PC who were randomized to radiation therapy (RT) or RT plus 6 months of ADT between 1995 and 2001. Fifty-four men who received salvage ADT for PSA failure after a median follow up of 18.72 years following randomization defined the study cohort. Fine-Gray competing risks regression analyzed whether the timing of salvage ADT was associated with an increased risk of PCSM after adjusting for age, comorbidity, known PC prognostic factors, and previously identified interactions. Results: After a median follow-up of 5.68 years (IQR 3.05 - 9.56) following salvage ADT 49 of the 54 men (91%) died, 27 from PC (54% of deaths). Increasing PSA-DT as a continuous covariate was associated with a decreasing risk of PCSM (adjusted hazard ratio [AHR] 0.33, 95% CI 0.13, 0.82; P=0.02). Amongst men with a long PSA-DT (≥6 months), initiating salvage ADT later (PSA>12ng/mL, upper quartile) versus earlier was associated with an increased risk of PCSM (AHR 8.84, 95% CI 1.99-39.27; P=0.004); whereas for men with a short (<6 months) PSA-DT (AHR 1.16, 95% CI 0.38-3.54; P=0.79) this was not true. Conclusions: Early initiation of salvage ADT for post-RT PSA recurrence in men with a PSA-DT of 6 months or more may reduce the risk of PCSM, arguing against the unproven assumption that patients with a short PSA-DT are those most likely to benefit from early initiation of salvage ADT. Clinical trial information: NCT00116220.

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