Baseline Cardiovascular Comorbidities & Mortality after Androgen Deprivation Therapy for Metastatic Prostate Cancer

[pjoshea13]

From an interesting 2020 study paper from Taiwan [1].

"ADT was associated with a 17-22% risk reduction in all-cause and PC-specific mortality in men without stroke, CAD {coronary arterial disease}, or CHF {congestive heart failure} in the 65-79-year group.

"The survival benefit diminished in men with any of these preexisting conditions.

"In contrast, ADT was not found to be associated with any survival benefit in the ≥80-year group, even though they did not present with any major cardiovascular disease at the baseline.

"Patients who had CHF, CAD, or stroke at the baseline did not show a survival benefit following ADT in any of the age groups.

"Men who have preexisting major cardiovascular diseases or are ≥80 years do not demonstrate a survival benefit from ADT for mPC. The risk-benefit ratio should be considered when using ADT for mPC in older men especially those with major cardiovascular comorbidities."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/319...

Full text: ncbi.nlm.nih.gov/pmc/articl...

Cancers (Basel)

. 2020 Jan 12;12(1):189. doi: 10.3390/cancers12010189.

Influence of Baseline Cardiovascular Comorbidities on Mortality after Androgen Deprivation Therapy for Metastatic Prostate Cancer

Szu-Yuan Wu 1 2 3 4 , Su-Chen Fang 5 , Olivia Rachel Hwang 6 , Hung-Jen Shih 7 8 , Yu-Hsuan Joni Shao 6 9

Affiliations collapse

Affiliations

1 Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.

2 Division of Radiation Oncology, Department of Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.

3 Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.

4 Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.

5 Department of Nursing, Mackay Medical College, New Taipei City 252, Taiwan.

6 Department, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei 110, Taiwan.

7 Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan.

8 Department of Urology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan.

9 Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan.

PMID: 31940958 PMCID: PMC7016583 DOI: 10.3390/cancers12010189

Free PMC article

Abstract

Few studies have assessed the benefits of androgen deprivation therapy (ADT) in men with metastatic prostate cancer (PC; mPC) at an old age or with major cardiovascular conditions. A retrospective cohort consisted of 3835 men with newly diagnosed mPC from the Taiwan Cancer Registry of 2008-2014. Among them, 2692 patients received only ADT in the first year after the cancer diagnosis, and 1143 patients were on watchful waiting. The inverse probability of treatment-weighted Cox model was used to estimate the effects of ADT on all-cause mortality and PC-specific mortality according to age, and the status of congestive heart failure (CHF), coronary arterial diseases (CADs), and stroke at the baseline. After a median follow-up of 2.65 years, 1650 men had died. ADT was associated with a 17-22% risk reduction in all-cause and PC-specific mortality in men without stroke, CAD, or CHF in the 65-79-year group. The survival benefit diminished in men with any of these preexisting conditions. In contrast, ADT was not found to be associated with any survival benefit in the ≥80-year group, even though they did not present with any major cardiovascular disease at the baseline. Patients who had CHF, CAD, or stroke at the baseline did not show a survival benefit following ADT in any of the age groups. Men who have preexisting major cardiovascular diseases or are ≥80 years do not demonstrate a survival benefit from ADT for mPC. The risk-benefit ratio should be considered when using ADT for mPC in older men especially those with major cardiovascular comorbidities.

Keywords: age; androgen deprivation therapy; cardiovascular diseases; prostate cancer; survival.

[monte1111]

Maybe the ADT will offset the Celebrex I'm taking.

[j-o-h-n in reply to monte1111]

You silly willy..... you're taking Celebrate not Celebrex.........

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/21/2021 6:59 PM DST

[monte1111 in reply to j-o-h-n]

Everything is the same pill. They just change the labels.

[j-o-h-n in reply to monte1111]

Poor bastard who has to lick them.............

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/21/2021 7:36 PM DST

[monte1111 in reply to j-o-h-n]

Are we changing the subject? Sorry Patrick.

[Hidden in reply to monte1111]

The take away is don't get old and definitely don't reach 80. Otherwise, everything is peaches and cream.

[j-o-h-n in reply to Hidden]

80....... huh,,,,, I'm writing that down....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/21/2021 9:40 PM DST

[monte1111 in reply to j-o-h-n]

That quill pen has gotta be around there somewhere.

[j-o-h-n in reply to monte1111]

I accidently bought a porcupine who had lost all it's quills....My wife said " Hey stupid, that was pointless"......

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 2:06 PM DST

[monte1111 in reply to Hidden]

I actually like the peaches and cream. Except for the Gerber brand.

[j-o-h-n in reply to monte1111]

Be aware and prepared,,,, the Gerber brand is all they serve in nursing homes....(Get the plastic bib with the ducks on it).....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 4:34 PM DST

[monte1111 in reply to j-o-h-n]

Sometimes I feel like I'm Flying Over the Cuckoo's Nest. It's certainly not Somewhere Over the Rainbow. Beware The Duck.

[j-o-h-n in reply to monte1111]

Sometimes I feel like a duck, sometimes I don't... 🎵

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 7:17 PM DST

[monte1111 in reply to j-o-h-n]

I think that is sometimes you feel like a nut, sometimes you don't....

[j-o-h-n in reply to monte1111]

That's it... Thanks.........I couldn't remember it..... now I don't have to stay up all night thinking about it..........You're my hero.......

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 9:45 PM DST

[monte1111 in reply to j-o-h-n]

Now, that is sarcasm. Go to bed.

[j-o-h-n in reply to monte1111]

Okay, good night...

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 10:47 PM DST

[j-o-h-n in reply to monte1111]

My wife made me change the subject..... maybe it's because I told her I wanted to buy a small white van so that the both of us could drive cross country and see all the scenic parks.....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 09/21/2021 9:37 PM DST

[longrungo2]

The age of the respondents and their sophomoric 'replies' lead one to wonder if they clearly understood/cared about the post, OR (since the data comes from Taiwan) if the banter was prompted by conscious or semi-conscious discounting of Asian lives.