TY - JOUR
T1 - First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality
T2 - results from SEARCH
AU - Griffin, Kagan
AU - Csizmadi, Ilona
AU - Howard, Lauren E.
AU - Pomann, Gina Maria
AU - Aronson, William J.
AU - Kane, Christopher J.
AU - Amling, Christopher L.
AU - Cooperberg, Matthew R.
AU - Terris, Martha K.
AU - Beebe-Dimmer, Jennifer
AU - Freedland, Stephen J.
N1 - Publisher Copyright:
© 2019, Springer Nature Switzerland AG.
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.
AB - Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.
KW - Androgen-deprivation therapy
KW - Metastases
KW - Prostate cancer
KW - Prostate cancer-specific mortality
KW - Weight gain
KW - Weight loss
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U2 - 10.1007/s10552-019-1133-5
DO - 10.1007/s10552-019-1133-5
M3 - Article
C2 - 30701374
AN - SCOPUS:85063526423
SN - 0957-5243
VL - 30
SP - 259
EP - 269
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 3
ER -