1820 CLINICAL OUTCOMES FOLLOWING PRIMARY ANDROGEN DEPRIVATION THERAPY AMONG MEN WITH LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 20121820 CLINICAL OUTCOMES FOLLOWING PRIMARY ANDROGEN DEPRIVATION THERAPY AMONG MEN WITH LOCALIZED PROSTATE CANCER Grace Lu-Yao, Dirk Moore, Weichung Shih, Yong Lin, Robert DiPaola, Hui Li, Peter Albertsen, and Siu-Long Yao Grace Lu-YaoGrace Lu-Yao New Brunswick, NJ More articles by this author , Dirk MooreDirk Moore New Brunswick, NJ More articles by this author , Weichung ShihWeichung Shih New Brunswick, NJ More articles by this author , Yong LinYong Lin New Brunswick, NJ More articles by this author , Robert DiPaolaRobert DiPaola New Brunswick, NJ More articles by this author , Hui LiHui Li New Brunswick, NJ More articles by this author , Peter AlbertsenPeter Albertsen Farmington, CT More articles by this author , and Siu-Long YaoSiu-Long Yao New Brunswick, NJ More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1886AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Primary androgen deprivation therapy (PADT) is commonly used among elderly patients despite uncertainty about its impact on disease progression. This study assessed the impact of PADT on further use of cancer therapy and risk of metastasis among men with localized prostate cancer (T1/T2) not undergoing local therapy. METHODS Medicare claims data linked to the Surveillance, Epidemiology and End Results (SEER) data were used to assemble a cohort of men over age 66 years diagnosed with T1/T2 prostate cancer in 1992-2007 without local therapy. To overcome potential biases associated with unmeasured confounding variables, we used instrumental variable analysis (IVA), a pseudo-randomization technique, to control for overt and hidden biases. Health service areas (HSAs) were used to define the instrumental variable. Low risk patients had Gleason scores < 7 in 2003-2007 and Gleason scores 2-7 in 1992-2002. RESULTS The population-based cohort consisted of 29,775 men, of which 39% received PADT. For the low-risk group, PADT was not associated with lower use of any cancer therapy (Hazard Ratio [HR] =1.02, 95% C.I.0.94-1.11) and was associated with increased usage of palliative cancer treatments (Hazard Ratio [HR] =1.15, 95% C.I. 1.03-1.29), chemotherapy (HR=1.23, 95% CI 1.00-1.51), and risk of metastases (HR=1.24, 95% CI 1.00-1.53). For the high risk group, there was a trend toward lower utilization of future cancer treatments and metastases, but the differences were not statistically significant. CONCLUSIONS For men over 66 years of age with low-risk prostate cancer, PADT does not reduce the risk of metastases or lower the usage of palliative treatments. The adverse effects of ADT should be weighed with the potential benefits when making treatment decisions. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e735 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Grace Lu-Yao New Brunswick, NJ More articles by this author Dirk Moore New Brunswick, NJ More articles by this author Weichung Shih New Brunswick, NJ More articles by this author Yong Lin New Brunswick, NJ More articles by this author Robert DiPaola New Brunswick, NJ More articles by this author Hui Li New Brunswick, NJ More articles by this author Peter Albertsen Farmington, CT More articles by this author Siu-Long Yao New Brunswick, NJ More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...