Patients with prostate cancer treated by ADT have significantly higher fibrinogenemia than healthy control

Žiaran, Stanislav; Gonçalves, F.; Breza, J

doi:10.1007/s00345-012-0926-x

Cited by 23 publications

(15 citation statements)

References 26 publications

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“…Thus, there may be residual confounding affecting the analysis of those on anti-androgen monotherapy. Alterations in lipid levels may be another mechanism through which systemic ADT is propagating risk of TED [26][27][28][29][30]. Our dataset does not contain information on any of these factors and thus further mechanistic studies are required to determine if these do play a role in the associations observed.…”

Section: Discussionmentioning

confidence: 99%

Risk of thromboembolic disease in men with prostate cancer undergoing androgen deprivation therapy

et al. 2015

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ObjectivesTo investigate the risk of thromboembolic disease (TED) in men with prostate cancer (PCa) on androgen deprivation therapy (ADT), while accounting for known TED risk factors. Materials and MethodsWe assessed TED risk for 42 263 men with PCa who were receiving ADT compared with a matched cohort of 190 930 without PCa. The associations between ADT and deep vein thrombosis (DVT) or pulmonary embolism (PE) were analysed using multivariate Cox proportional hazard regression models, while accounting for previous PCa-related surgeries and the following proxies for disease progression: transurethral resection of the prostate, palliative radiotherapy and nephrostomy. ResultsBetween 1997 and 2013, 11 242 men with PCa received antiandrogen monotherapy, 26 959 men received gonadotropinreleasing hormone (GnRH) agonists, 1 091 men received combined androgen blockade and 3 789 men underwent orchiectomy. When accounting for previous surgeries and proxies of disease progression, GnRH agonist users and surgically castrated men had a higher risk of TED than the comparison cohort: hazard ratios (HRs) 1.67 (95% confidence interval [CI] 1.40-1.98) and 1.61 (95% CI 1.15-2.28), respectively. Men on anti-androgen monotherapy had a lower risk: HR for DVT 0.49 (95% CI 0.33-0.74). TED risk was highest among those who switched from anti-androgen to GnRH agonists: HR for PE 2.55 (95% CI 1.76-3.70). This increased from 2.52 (95% CI 1.54-4.12) in year 1, to 4.05 (95% CI 2.51-6.55) in year 2. ConclusionThe incidence of TED among men on ADT increased with the duration of therapy and the risk was highest for those who switched regimen, suggesting that disease progression as well as ADT contribute to the propagation of TED risk. Nonetheless, these findings support the hypothesis that only men with a relevant indication should receive systemic ADT.

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Section: Discussionmentioning

confidence: 99%

Risk of thromboembolic disease in men with prostate cancer undergoing androgen deprivation therapy

et al. 2015

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“…25 Hypercoagulability is a direct pathophysiological factor contributing to symptomatic TE and CV complications. 26,27 However, increased intravascular hypercoagulability, a proposed mechanism of early TE events in cancer patients, has not been examined systematically in association with ADT.…”

Section: Discussionmentioning

confidence: 99%

“…27 However, this study did not use TEG as a global, sensitive measure of hypercoagulability and did not include PCa patients on watchful waiting as controls. The findings in the current study may complicate consideration of management of the potential hypercoagulable state in PCa patients relative to previous studies.…”

Section: Discussionmentioning

confidence: 99%

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Kaur¹,

Black

Robb

et al. 2017

CUAJ

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Introduction: Androgen-deprivation therapy (ADT) is the mainstay of systemic therapy for advanced prostate cancer (PCa), but has significant adverse effects, including increasing concern for cardiovascular (CV) and thromboembolic (TE) complications. This study carefully investigates any relationship between ADT use and hypercoagulability as a possible mechanism of these adverse effects. Methods: We performed a prospective, longitudinal study in a cohort of patients with advanced PCa initiating ADT (n=18). Controls included men with biochemical failure after local therapy on watchful waiting (n=10), as well as healthy controls (n=8). Global hemostasis was evaluated using the sensitive global hemostasis assay, thromboelastography (TEG). Patients were evaluated at baseline and every three months for a minimum of 12 months. Results: The results of the TEG studies demonstrated 14/18 (78%) of advanced PCa patients had evidence of a hypercoagulable state before initiating therapy. Significant baseline hypercoagulability was documented in this cohort compared to the two control groups. ADT did not appear to exacerbate hypercoagulability over time as a whole: only 10/18 (56%) patients had TEG findings consistent with hypercoagulability at the end of study. However, 3/18 (17%) PCa patients initiating ADT had significantly new hypercoagulable TEG changes on treatment compared to baseline. Conclusions: This prospective pilot study demonstrates a complex interaction between ADT and hypercoagulable state in men with advanced PCa. TEG abnormalities were mostly associated with volume of cancer as compared to ADT use; however, it is possible that ADT may lead to hypercoagulability in a subset of men, suggesting that sensitive monitoring of coagulation of men on ADT could help identify those at risk of developing CV/TE complications. Study limitations include the relatively small cohort of men followed after initiating ADT and these results require confirmation in a larger trial to rule out subtle effects on hypercoagulability.

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“…Extensive study allow definitively determine the diagnostic and prognostic markers with the highest informative value suitable not only for urinary bladder cancer, but also for other malignancies (Cariaga-Martinez et al, 2013;Ziaran et al, 2013).…”

Section: Disscussionmentioning

confidence: 99%

Immunohistochemical Analysis of Urothelial Bladder Cancers

Bevizova¹

2013

OnLine Journal of Biological Sciences

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Malignant cancers of urinary bladder are the second most common malignancy of the urinary tract and the fourth most common malignancy in general, especially in men. The aim of this study was a retrospective analysis of selected markers (p53, Ki-67 and E-cadherin) of urinary bladder cancers from the Department of Urology in Bratislava, Slovak Republic between years 2007 and 2009. We analysed 244 patients (202 males, 42 females) with diagnosed bladder cancer via cystoscopy and subsequent transurethral resection. Patients' age varied from 36 to 98 years. Obtained samples were fixed by 10% buffered formalin for 24 to 48 h. Subsequently, they were dehydrated in ascending ethanol series and embedded in paraffin. The parafin sections of 5 µ m were prepared by microtome and they were stained by haematoxylin and eosin. The antibodies against to p53, Ki-67 and E-cadherin were used in immunohistochemical analysis. Statistical evaluation was performed via SPSS using non-parametric Kruskal-Wallis test and p values<0.05 were considered statistically significant. No significant differences in the expression of selected markers were found between genders. Expression of p53 and Ki-67, in G1 and G2 of low grade tumours was lower in comparison to their expression in G3 tumors. Expression of E-cadherin was the opposite in this case. The expression of p53 and Ki-67 positively correlated with tumor's depth of invasion, while the expression of E-cadherin significantly decreased. In case of T4 tumors, the expression of all markers exhibited consistently high values. When analysing tumor multiplicity, the expression of p53 and Ki-67 significantly decreased, while the expression of E-cadherin significantly increased. Based on the obtained results it can be concluded that the analysis of p53, Ki-67 and E-cadherin expression is essential for diagnostics and prognostics of bladder cancer and should be routinely used in daily practise together with "conventional" markers to improve prognosis estimation.

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Patients with prostate cancer treated by ADT have significantly higher fibrinogenemia than healthy control

Abstract: This is the first study that demonstrates the significant increase in FB in PCa patients on ADT, while CRP as inflammatory marker did not increase. Elevation of SF may contribute to increased CVR in PCa patients. Further prospective studies are warranted to confirm this association.

Cited by 23 publications

References 26 publications

Risk of thromboembolic disease in men with prostate cancer undergoing androgen deprivation therapy

Risk of thromboembolic disease in men with prostate cancer undergoing androgen deprivation therapy

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Immunohistochemical Analysis of Urothelial Bladder Cancers

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