Gonadotropin-releasing Hormone Agonists and Acute Kidney Injury in Patients with Prostate Cancer

Gandaglia, Giorgio; Sun, Maxine; Hu, Jim C.; Novara, Giacomo; Choueiri, Toni K.; Nguyen, Paul L.; Schiffmann, Jonas; Graefen, Markus; Shariat, Shahrokh F.; Abdollah, Firas; Briganti, Alberto; Montorsi, Francesco; Trinh, Quoc Dien; Karakiewicz, Pierre I.

doi:10.1016/j.eururo.2014.01.026

Cited by 34 publications

(33 citation statements)

References 28 publications

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“…(5) In addition, an increased risk of acute kidney injury has recently been reported with ADT. (7, 8) These observational studies are often limited due to selection bias and lack of detailed information on treatments and prognostic factors.…”

Section: Introductionmentioning

confidence: 99%

Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer

et al. 2016

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Importance Although intermittent androgen deprivation therapy (ADT) has not been associated with better overall survival in prostate cancer (PC), it has the potential for lower side effects. The incidence of long-term adverse health events has not been reported. Objective Given that older patients are more likely to suffer long-term complications from ADT, we examined long-term late events in elderly patients randomized to intermittent or continuous ADT. Our hypothesis was that late cardiovascular and endocrine events would be lower in patients on intermittent ADT. Design Linkage between patient trial data and corresponding Medicare claims. Setting Multicenter clinical trial. Participants Patients from S9346, a randomized SWOG trial of intermittent vs. continuous ADT in men with metastatic PC. Main Outcomes and Measures The main outcome was to identify long-term adverse health events by treatment arm. Patients were classified as having an adverse health event if they had any hospital claim – or at least 2 physician or outpatient claims at least 30 days apart – for any of the following diagnoses: ischemic and thrombotic events; endocrine events; sexual dysfunction, dementia and depression. To incorporate time from beginning of observation through evidence of an event, we determined the cumulative incidence of each event. Competing risks Cox regression was used, adjusting for covariates. Results In total, n=1134 eligible U.S.-based patients with metastatic PC were randomized to continuous vs. intermittent ADT on S9346. A total of 636 (56%) of trial participants had ≥1 year of continuous Medicare parts A & B coverage and no HMO participation. The median age was 71.3 years. The most common long-term events were hypercholesterolemia (31%) and osteoporosis (19%). The 10-year cumulative incidence of ischemic and thrombotic events differed by arm; 24% for continuous and 33% for intermittent ADT (Hazard Ratio=0.69, p=.02). There were no statistically significant differences by arm in any other adverse health events. Conclusions and Relevance Contrary to our hypothesis that intermittent ADT would reduce long-term health-related events compared to continuous ADT, we found that older men assigned to intermittent ADT had no apparent reduction in bone, endocrine, or cognitive events and an increased incidence of ischemic and thrombotic events.

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Section: Introductionmentioning

confidence: 99%

Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer

et al. 2016

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“…Comparative effectiveness of open versus robot-assisted RP [78] Impact of primary ADT on survival in men with clinically localized PCa [119] ADT and the risk of cardiovascular diseases, diabetes, fractures, and acute kidney injury in PCa patients [120,121] Racial disparities and geographic variations in primary treatments among PCa patients [64] Increased use of advanced treatment technologies among patients with low-risk PCa and high risk of non-cancer-related mortality [122] Cost implications of the introduction and widespread adoption of advanced treatment technologies for PCa [103] PCOS: Prostate Cancer Outcomes Study Association between age, race, and comorbidity and the probability of receiving a conservative treatment [67] Comparative effectiveness of radical prostatectomy and radiation therapy [37] 15-yr (long-term) disease-specific functional outcomes after RP and radiotherapy [35] …”

Section: 4mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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“…Bu çalışma, GnRH analoglarının Akut Böbrek Yetmezliği'ne (ABY) giden süreçleri hızlandırdığını ortaya koymuştur. Ancak orşiektominin ABY ile ilişkisi görülmemiştir (19). DABT, metabolik sendrom ve kemik mineral dansitesinde azalma gibi uzun dönem yan etkilerin ortaya çıkmasıyla ilişkilidir.…”

Section: Yan Etkiler Ve Yaşam Kalitesiunclassified

Intermittent Versus Continuous Androgen Deprivation in Patients with Metastatic Prostate Cancer: Review

Yıldızhan¹,

Dündar²,

Ertek³

2015

uob

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Gonadotropin-releasing Hormone Agonists and Acute Kidney Injury in Patients with Prostate Cancer

Cited by 34 publications

References 28 publications

Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer

Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer

Prostate Cancer Registries: Current Status and Future Directions

Intermittent Versus Continuous Androgen Deprivation in Patients with Metastatic Prostate Cancer: Review

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