MP73-11 ANDROGEN DEPRIVATION THERAPY AND INCREASED NON-CANCER MORTALITY IN PROSTATE CANCER PATIENTS: ANALYSIS OF THE NUMBER NEEDED TO TREAT

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2015MP73-11 ANDROGEN DEPRIVATION THERAPY AND INCREASED NON-CANCER MORTALITY IN PROSTATE CANCER PATIENTS: ANALYSIS OF THE NUMBER NEEDED TO TREAT Firas Abdollah, Jesse Sammon, Akshay Sood, Daniel Pucheril, Dane Klett, Maxine Sun, Ayal Aizer, Toni Choueiri, Jim Hu, Simon Kim, Adam Kibel, Paul Nguyen, Mani Menon, and Quoc-Dien Trinh Firas AbdollahFiras Abdollah More articles by this author , Jesse SammonJesse Sammon More articles by this author , Akshay SoodAkshay Sood More articles by this author , Daniel PucherilDaniel Pucheril More articles by this author , Dane KlettDane Klett More articles by this author , Maxine SunMaxine Sun More articles by this author , Ayal AizerAyal Aizer More articles by this author , Toni ChoueiriToni Choueiri More articles by this author , Jim HuJim Hu More articles by this author , Simon KimSimon Kim More articles by this author , Adam KibelAdam Kibel More articles by this author , Paul NguyenPaul Nguyen More articles by this author , Mani MenonMani Menon More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2687AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In prostate cancer (PCa) patients, the relationship between androgen deprivation therapy (ADT) and other-cause mortality (OCM), and the magnitude of this potential relationship has not been fully elucidated. The objective of this study is to examine and quantify the association of ADT with OCM in PCa patients treated with primary ADT, prostatectomy, or radiation. METHODS A total of 137,524 patients with non-metastatic PCa treated between 1995 and 2009 within the Surveillance Epidemiology and End Results Medicare-linked database were included. Cox-regression analysis and the number needed to harm (NNH) were used to respectively test and quantify the association of ADT with OCM. A 40-item comorbidity score was used for adjustment. RESULTS Overall, 9.3% of patients harbored stage III-IV disease, and 57.7% of patients received ADT. The mean duration of ADT exposure was 22.9 months (median: 9.1; IQR: 2.8-31.5). Mean and median follow-up were 66.9, and 60.4 months, respectively. At 10 years, overall OCM rate was 36.5%; it was 30.6% in patients treated without ADT vs. 40.1% in patients treated with ADT (p<0.001). This translated into a number need to harm (NNH) of 10.5. In multivariable analysis, ADT was associated with an increased risk of OCM (hazard ratio: 1.11, 95% confidence interval: 1.08-1.13). Patients with no comorbidity (10-year NNH: 11.1) were more subject to harm from ADT than patients with high comorbidity (10-year NNH: 21.3). CONCLUSIONS In patients with PCa, treatment with ADT may increase the risk of mortality due to causes other than prostate cancer. The NNH was 10.5. Whether this is a simple association or a cause-effect relationship is unknown and warrants further study in prospective studies. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e934 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Firas Abdollah More articles by this author Jesse Sammon More articles by this author Akshay Sood More articles by this author Daniel Pucheril More articles by this author Dane Klett More articles by this author Maxine Sun More articles by this author Ayal Aizer More articles by this author Toni Choueiri More articles by this author Jim Hu More articles by this author Simon Kim More articles by this author Adam Kibel More articles by this author Paul Nguyen More articles by this author Mani Menon More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...