Androgen deprivation and thromboembolic events in men with prostate cancer Journal Article

Authors: Ehdaie, B.; Atoria, C. L.; Gupta, A.; Feifer, A.; Lowrance, W. T.; Morris, M. J.; Scardino, P. T.; Eastham, J. A.; Elkin, E. B.
Article Title: Androgen deprivation and thromboembolic events in men with prostate cancer
Abstract: BACKGROUND: Androgen deprivation therapy (ADT) improves prostate cancer outcomes in specific clinical settings, but is associated with adverse effects, including cardiac complications and possibly thromboembolic complications. The objective of this study was to estimate the impact of ADT on thromboembolic events (TEs) in a population-based cohort. METHODS: In the linked Surveillance, Epidemiology and End Results-Medicare database, we identified men older than 65 who were diagnosed with nonmetastatic prostate cancer between 1999 and 2005. Medical or surgical ADT was identified by Medicare claims for gonadotropin-releasing hormone agonists or bilateral orchiectomy at any time following diagnosis. TEs included deep venous thrombosis, pulmonary embolism, and arterial embolism. The impact of ADT on the risk of any TE and on total number of events was estimated, controlling for patient and tumor characteristics. RESULTS: Of 154,611 patients with prostate cancer, 58,466 (38%) received ADT. During a median follow-up of 52 months, 15,950 men had at least 1 TE, including 8829 (55%) who had ADT and 7121 (45%) with no ADT. ADT was associated with increased risk of a TE (adjusted hazard ratio = 1.56; 95% confidence interval, 1.50-1.61; P <.0001), and duration of ADT was associated with the total number of events (P <.0001). CONCLUSIONS: In this population-based cohort, ADT was associated with increased risk of a TE, and longer durations of ADT were associated with more TEs. Men with intermediate- and low-risk prostate cancer should be assessed for TE risk factors before starting ADT and counseled regarding the risks and benefits of this therapy. © 2011 American Cancer Society.
Keywords: controlled study; aged; aged, 80 and over; major clinical study; risk benefit analysis; treatment duration; follow up; cancer diagnosis; cohort analysis; deep vein thrombosis; data base; high risk patient; risk assessment; prostate cancer; lung embolism; pulmonary embolism; prostatic neoplasms; medicare; population research; thromboembolism; androgen antagonists; cancer epidemiology; gonadorelin agonist; orchiectomy; androgen deprivation therapy; gonadotropin-releasing hormone; prostate surgery; venous thrombosis; androgen deprivation; artery embolism; arterial embolism
Journal Title: Cancer
Volume: 118
Issue: 13
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2012-07-01
Start Page: 3397
End Page: 3406
Language: English
DOI: 10.1002/cncr.26623
PUBMED: 22072494
PROVIDER: scopus
PMCID: PMC3678973
Notes: --- - "Cited By (since 1996): 4" - "Export Date: 9 January 2013" - "CODEN: CANCA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Michael Morris
    280 Morris
  2. Peter T Scardino
    621 Scardino
  3. Elena B Elkin
    151 Elkin
  4. Andrew Feifer
    18 Feifer
  5. Amit Gupta
    10 Gupta
  6. Behfar Ehdaie
    75 Ehdaie
  7. James Eastham
    427 Eastham
  8. Coral Lynn Atoria
    49 Atoria