The rising prevalence of androgen deprivation among older American men since the advent of prostate‐specific antigen testing: a population‐based cohort study

Barry, Michael J.; DeLorenzo, M.A.; Walker-Corkery, Elizabeth; Lucas, F. Lee; Wennberg, David C.

doi:10.1111/j.1464-410x.2006.06416.x

Cited by 85 publications

(62 citation statements)

References 35 publications

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“…Although other studies showed marked increases in the use of ADT for men with nonmetastatic disease since the early 1990s [8][9][10], for both white and black men [22], there were no similar increases in the use of ADT for metastatic disease during this time.…”

Section: Discussionmentioning

confidence: 83%

“…The use of ADT has increased greatly since the early 1990s among American men with nonmetastatic prostate cancer [8][9][10], but few data are available about patterns of ADT in men with metastatic prostate cancer. A recent study of men who died from prostate cancer during 1991-2000 found that about a quarter of men did not receive ADT before death, and black men were much less likely than white men to receive ADT [11].…”

Section: Introductionmentioning

confidence: 99%

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Use of androgen deprivation therapy for metastatic prostate cancer in older men

et al. 2008

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OBJECTIVETo assess factors associated with early or delayed androgen deprivation therapy (ADT) among men diagnosed with metastatic prostate cancer, and to assess the relationship between ADT and overall survival, as there is uncertainty about the ideal timing for initiating ADT in men with metastatic prostate cancer.PATIENTS AND METHODSWe studied a population‐based cohort of American men aged ≥66 years diagnosed with metastatic prostate cancer during 1992–2002 and followed to 2003. We assessed the receipt of ADT early (≤4 months from diagnosis), delayed (>4 months), or not at all, using multinomial logistic regression to identify factors associated with treatment, and Cox proportional‐hazard models to assess whether treatment was associated with survival.RESULTSOverall, 69.5% of men received early ADT and 7.3% delayed. Adjusted rates of early ADT were lower for black than white men (58.3% vs 71.0%), and of delayed ADT were higher for black than white men (12.7% vs 6.2%). Receipt of ADT was associated with improved survival (adjusted hazard ratio 0.69, 95% confidence interval 0.66–0.73). The benefit of early treatment did not differ from delayed treatment (P = 0.58).CONCLUSIONSA large minority of men with metastatic prostate cancer, particularly black men, receive delayed or no ADT. Early or delayed ADT was associated with similarly prolonged survival. After controlling for patient and tumour characteristics, survival did not differ by race, and receipt of ADT did not contribute to racial differences in survival.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Use of androgen deprivation therapy for metastatic prostate cancer in older men

et al. 2008

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“…4 Since Huggins et al 5 demonstrated the androgen dependence of prostate cancer, androgen deprivation therapy (ADT) has been increasingly applied in the treatment for prostate cancer. ADT with gonadotropin-releasing hormone agonist or bilateral orchiectomy is the mainstay of treatment for metastatic and recurrent prostate cancer 6 and may be beneficial to men with locally advanced disease. [7][8][9] Although ADT offers important clinical benefits, it is associated with a variety of complications such as hot flushes, anaemia, sexual dysfunction, changing body composition, osteoporosis and fractures, and increased risk for diabetes and cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Androgen deprivation therapy through bilateral orchiectomy: increased metabolic risks

Jiang¹,

Zhang²,

Zhang³

et al. 2011

Asian J Androl

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Prostate cancer is one of the most common malignancies in men. Previous research has determined that androgen deprivation therapy (ADT) may be accompanied by an unfavourable metabolic profile. In this prospective study, 133 men were recruited, including 46 prostate cancer patients who had undergone bilateral orchiectomy and been on flutamide (the ADT group), 37 men with prostate cancer who had undergone radical prostatectomy (the non-ADT group) and 50 normal control subjects (the control group). All subjects were followed for at least 12 months. From baseline to 3 months, men in the ADT group had increased levels of fasting serum insulin and low-density lipoprotein compared to the other two groups (P,0.05). No obvious changes were found in the other parameters (P.0.05). After 12 months, men in the ADT group had increased levels of waist circumference, fasting serum insulin and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein compared to the other two groups (P,0.05). Additionally, the morbidity rate of metabolic syndrome in the ADT group was higher (P,0.05) compared to the other two groups. ADT through surgical castration for men with prostate cancer may be associated with unfavourable metabolic changes. The benefits of the therapy should be balanced prudently against these risks.

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“…The results showed an impressive improvement in survival rate, and this success led to numerous studies exploring this concept. In addition, with the longer duration of LHRH dosage intervals and the reduced negative impact to patients' selfimage and cosmetic appearance [7,8] , LHRH agonist therapy became more popular than surgical castra tion [22,23] . Because medical castration is reversible and has less of a psychiatric impact than surgical castration, several new trials have been conducted in different clinical situations.…”

Section: Wwwchinapharcom Lin Yh Et Almentioning

confidence: 99%

A comparison of androgen deprivation therapy versus surgical castration for patients with advanced prostatic carcinoma

Lin¹,

Chen²,

Hou³

et al. 2011

Acta Pharmacol Sin

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Aim: To examine the outcomes of patients with advanced prostate carcinoma who underwent medical or surgical castration. Methods: A hundred twenty one consecutive cases of patients with advanced prostate carcinoma who underwent medical or surgical castration between 2001 and 2006 were retrospectively reviewed. Associations between clinical outcomes and prognostic scoring factors were determined based on the Reijke study. In the surgical and medical castration groups, the impact on the prostate-specifi c antigen (PSA) normalization rate, the rebound rate and the disease-free survival rate were evaluated. The mean follow-up was 36.1 months. Results: In the initial 12 months, there were no statistical differences in the PSA normalization rate and the PSA rebound rate between the two groups. However, the PSA rebound rate after the 12th month (20.90% vs 40.74%, P=0.0175) and the 18th month PSA normalization rate (59.70% vs 37.04%, P=0.0217) differed signifi cantly between the two groups, and these differences were maintained to the end of the study. When comparing patients grouped according to Reijke prognosis scores, there was no difference between medical and surgical castration for the good prognosis group. However, among the patients given a poor prognosis, surgical castration was superior in terms of the PSA normalization rate, the PSA rebound rate, the tumor progression-free survival rate (P<0.001) and the overall survival rate (P<0.001). Conclusion: Advanced prostate carcinoma patients with poor pretreatment prognosis scores should undergo surgical castration rather than medical castration for better PSA rebound rates and overall survival.Keywords: androgen; surgical castration; prostate neoplasm; metastasis; prognosis; medical castration; prostate-specifi c antigen; luteinizing hormone-releasing hormone (LHRH) Acta Pharmacologica Sinica (2011) 32: 537-542; doi: 10.1038/aps.2010 published online 14 Mar 2011 Original Article # The two authors contributed equally to this work. * To whom correspondence should be addressed. In this study, we compared the clinical effectiveness of surgical and medical castration with respect to patient outcomes. We also identifi ed clinical outcomes and PSA response features that predicted favorable treatment outcomes for prostate carcinoma after ADT. Materials and methods Patient selectionAfter obtaining institutional review board approval for a retrospective study of the medical records from January 2001 to March 2006, we identified all patients who had advanced prostate carcinoma. Patients with localized prostate carcinoma received definitive therapy, such as radical surgery or radiotherapy. Patients whose clinical staging was greater than tumor stage T3, T4, or metastatic disease, received hormone therapy. In this study, we included these patients receiving hormone therapy but excluded patients on radiotherapy or chemotherapy for prostate carcinoma. However, there were some patients on palliative radiotherapy for spinal or other bone metastases.The exclusion criteria for this...

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The rising prevalence of androgen deprivation among older American men since the advent of prostate‐specific antigen testing: a population‐based cohort study

Cited by 85 publications

References 35 publications

Use of androgen deprivation therapy for metastatic prostate cancer in older men

Use of androgen deprivation therapy for metastatic prostate cancer in older men

Androgen deprivation therapy through bilateral orchiectomy: increased metabolic risks

A comparison of androgen deprivation therapy versus surgical castration for patients with advanced prostatic carcinoma

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