Parenteral estrogen versus total androgen ablation in the treatment of advanced prostate carcinoma: effects on overall survival and cardiovascular mortality

Hedlund, Per Olov; Henriksson, Peter

doi:10.1016/s0090-4295(99)00580-4

Cited by 70 publications

(38 citation statements)

References 16 publications

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“…In the original paper, no difference was found in overall survival in the two treatment groups (19). In the present study of 106 patients, their survival was independent of treatment; thus, all patients were evaluated together for survival analysis.…”

Section: Methodsmentioning

confidence: 56%

“…Retrospective, longitudinal study included 106 men (median age, 72; range, 54-89 years) with metastatic PC (stage T1-4, Nx, M+, Soloway score 1-3) and a WHO performance status of 0 to 2. The patients were enrolled from five Danish hospitals and included in the Scandinavian Prostate Cancer Group-5 study of patients with metastatic PC (19). The patients were included between November 1993 and June 1996 and randomized to treatment with either total androgen ablation (either bilateral orchiectomy or triptorelin 3.75 mg/mo combined with the antiandrogen flutamide 250 mg thrice daily) or parenteral estrogen [i.m.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival

Johansen

Brasso

Iversen

et al. 2007

Clinical Cancer Research

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Purpose: Elevated serum levels of biochemical markers of bone turnover and YKL-40 in patients with metastatic prostate cancer (PC) at the time of diagnosis are associated to poor prognosis. In this study, we evaluated the value of these biomarkers in monitoring the patients during hormonal treatment. Experimental Design: Serum procollagen type I N-terminal propeptide (PINP), bone-specific alkaline phosphatase (BAP), CTX-I, andYKL-40 were determined by ELISA in a longitudinal study of 106 patients with metastatic PC during treatment with total androgen ablation or parenteral estrogen. Serum samples were collected with 3 months interval. Median observation time was 4.9 years (range, 3.6-6.2). A total of 78 patients died (64 within 7 months following the last blood sampling).Results: After 6 months treatment, serum PINP, BAP, and YKL-40 decreased (P < 0.0001), but not serum CTX-I compared with baseline values. Univariate Cox analysis showed that serum PINP at 6 months [log transformed and treated as a continuous variable; hazard ratio (HR), 2.2; P < 0.0001], serum BAP (HR, 1.8; P < 0.0001), and serum CTX-I (HR, 2.4; P < 0.0001), but not serum YKL-40 (HR, 1.4; P = 0.16) were associated with survival. Multivariate Cox analysis including the biomarkers 6 months after the start of treatment showed that Soloway score (HR, 3.9; P = 0.013), WHO tumor grade (HR, 3.9; P = 0.004), and serum PINP (HR, 2.2; P < 0.0001) were independent prognostic variables of survival. Scoring the biomarkers during treatment as time-dependent covariates in univariate Cox regression analysis showed that increases in serum PINP (HR, 2.0; P < 0.0001), BAP (HR, 2.1; P < 0.0001), and YKL-40 (HR, 2.1; P < 0.0001) were predictors of early death. Conclusions: Serial monitoring of serum PINP, BAP, CTX-I, andYKL-40 in metastatic PC patients during hormonal treatment provided information of prognosis.Prostate cancer (PC), the most frequent cancer in males, is responsible for f27,350 deaths in the United States in 2006 (1). The optimal management of patients with metastatic PC is still a question open for debate (2). The ongoing discussions reflect the fact that once patients have developed metastatic disease and the PC has become hormone refractory, the prognosis is poor (3). Bone is the most common site of PC spread and accounts for up to 80% of all PC metastases, and 85% to 100% of those who die from PC have bone metastases (3). The high frequency and poor prognosis of patients with metastatic PC emphasize the need for good biomarkers of treatment response, disease progression, and short survival to optimize treatment of PC patients.Several biomarkers (defined as physical signs or laboratory measurements that occur in association with a pathologic process or that have putative and/or prognostic utility; ref. Research.on May 11, 2018. © 2007 American Association for Cancer clincancerres.aacrjournals.org Downloaded from metastasis (5 -12). Recently, three large studies of PC patients with bone metastases showed that high serum CTX-I and NTX-I (8...

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Section: Methodsmentioning

confidence: 56%

Section: Methodsmentioning

confidence: 99%

Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival

Johansen

Brasso

Iversen

et al. 2007

Clinical Cancer Research

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“…[2] Attention has been paid to the relationship between androgenic hormones and cardiovascular system (CVS) after the observation that rates of CV mortality, thrombogenic events. [4] increase with diethylstilbestrol (DES) [3] which is used in prostate cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

The relationship between lipoprotein-associated phospholipase A2 with cardiovascular risk factors in testosterone deficiency

Kızılay

Barutçuoğlu

Basol

et al. 2018

Turkish Journal of Urology

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Objective: Lipoprotein-associated phospholipase A2 (Lp-PLA2) which is believed to play a role in atherosclerotic inflammatory process due to its function in hydrolysis of phospholipids and release of proinflammatory products, is considered as a novel biomarker for vascular risk. In this study we aimed to investigate the alterations in Lp-PLA2 and its relationship with other cardiovascular risk factors in patients with testosterone deficiency. Material and methods:Forty hypogonadic male and 30 healthy male aged between 18-50 years were enrolled in this study. Height-weight, waist-to-hip circumference, body mass index (BMI) blood pressure, and body fat measurements were performed in all subjects. Blood glucose, albumin, total cholesterol, HDLcholesterol, LDL-cholesterol, triglycerides, high sensitive C-reactive protein (hs-CRP), apo-A1, apo-B, fibrinogen, insulin, total testosterone, sex hormone binding globulin (SHBG), small dense low-density lipoprotein (sd-LDL), paraoxonase 1, oxidized low-density lipoprotein (ox-LDL) and Lp-PLA 2 values were measured. Free and bioavailable testosterone levels were calculated. Data management was carried out with the statistical program SAS Version 9.2. Statistical evaluations were performed using Analysis of Variance (ANOVA), Kruskal-Wallis test, Wilcoxon test, correlation analysis and chi-square analysis. P values <0.05 were considered statistically significant. Results:In patients with hypogonadism, significant increase in Lp-PLA2 levels were accompanied with risk factors of atherosclerosis, such as increase in total cholesterol, apo-B, sd-LDL, weight, BMI, body fat percentage, and decrease in paraoxonase 1 levels. Although the differences were not significant, similarly ox-LDL, hs-CRP, triglyceride, LDL-cholesterol levels were found to be higher in patients with hypogonadism compared to the control group. The mean level of Lp-PLA2 was the highest when compared with the group of secondary hypogonadism with the lowest testosterone level. Conlusion:Our study has demonstrated that the testosterone deficiency increases cardiovascular risk via its effects on lipid metabolism and Lp-PLA2 can be used to assess this risk. The relationship between lipoprotein-associated phospholipase A2 with cardiovascular risk factors in testosterone deficiency Introduction Nowadays, mortality linked to cardiovascular (CV) events ranks first among all mortality causes.[1] There is strong evidence that androgen deficiency is associated with atherosclerosis.[2] Attention has been paid to the relationship between androgenic hormones and cardiovascular system (CVS) after the observation that rates of CV mortality, thrombogenic events.[4] increase with diethylstilbestrol (DES) [3] which is used in prostate cancer treatment.It has been reported that androgen deficiency promotes processes leading to atherosclerosis such as oxidative stress, endothelial dysfunction and proinflammatory factors by affecting lipid profile and all of the components of the metabolic syndrome accompany hypogonadism, but c...

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“…The symptomatic improvement in pain and performance status appeared to be temporally associated with changes in objective response markers, and it is suggested that the main mechanism of action of this combination therapy affects mechanisms regulating the growth and/or survival of metastatic cells rather than involving a non-specific antiinflammatory or analgesic effect. 24 The median duration of the bone pain response, ECOG response and progression-free survival was 17.5 (95% CI 12-19), 18 (95% CI 12-19) and 18.5 (95% CI 14-21) months, respectively, in the authors' study and 13 (95% CI 12-14), 19 (95% CI [13][14][15][16][17][18][19][20][21][22][23][24][25] and seven (95% CI three to 10) months in the study by Koutsilieris et al 24 A comparison of serum CgA at baseline during followup, at maximal response and at relapse from therapy, revealed a significant change in CgA during the course of combination therapy (Friedman's non-parametric two-way analysis of variance (ANOVA); p<0.0001). The authors observed a significant decrease in serum CgA during the administration of combination therapy (median maximum decrease 38.4%, 95% CI 33.2-50.3, range 28.6%-64.9%) compared with baseline CgA.…”

Section: S O M a T O S T A T I N A N A L O G U E S I N C O M B I N A mentioning

confidence: 66%

“…12 Another trial also showed superior results over anti-androgen monotherapy. 13 Interest in oestrogen therapy has also been rekindled by recent trials, suggesting that the parenteral administration of oestrogens may avoid a majority of cardiovascular (CV) toxicity. Most recently, Ockrim et al 14 reported encouraging biochemical results in 20 patients with locally advanced or metastatic cancer treated with transdermal oestradiol patches.…”

Section: E F F E C T O F N O N -S T E R O I D a L A N T I -A N D R O mentioning

confidence: 99%

Androgen Deprivation Therapy and Neuroendocrine Differentiation in Prostate Carcinoma – A Possible Inductive Role

Sciarra¹,

Albanesi²,

Fattore³

et al. 2006

European Endocrinology

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Parenteral estrogen versus total androgen ablation in the treatment of advanced prostate carcinoma: effects on overall survival and cardiovascular mortality

Cited by 70 publications

References 16 publications

Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival

Changes of Biochemical Markers of Bone Turnover and YKL-40 Following Hormonal Treatment for Metastatic Prostate Cancer Are Related to Survival

The relationship between lipoprotein-associated phospholipase A2 with cardiovascular risk factors in testosterone deficiency

Androgen Deprivation Therapy and Neuroendocrine Differentiation in Prostate Carcinoma – A Possible Inductive Role

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