Hormone therapy for prostate cancer and the risk of stroke: a 5‐year follow‐up study

• Published in: BJU international 2012-04, Vol.109 (7), p.1001-1005
• Main Authors: Chung, Shiu‐Dong, Chen, Yi‐Kuang, Wu, Fang‐Jen, Lin, Herng‐Ching
• Format: Article
• Language: English
• Subjects: Aged; Androgen Antagonists - adverse effects; Androgen Antagonists - therapeutic use; androgen deprivation therapy; Antineoplastic Agents, Hormonal - adverse effects; Antineoplastic Agents, Hormonal - therapeutic use; Biological and medical sciences; Cardiovascular disease; Confidence intervals; Disease-Free Survival; epidemiology; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Nephrology. Urinary tract diseases; prostate cancer; Prostatic Neoplasms - complications; Prostatic Neoplasms - drug therapy; Stroke; Stroke - chemically induced; Taiwan; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10459.x

Study Type – Therapy (outcomes) Level of Evidence 2c What's known on the subject? and What does the study add? Numerous studies have consistently reported that long‐term use of ADT for PC may increase the risk of fractures, metabolic syndrome and cardiovascular diseases. There was no significant difference in risk of stroke between ethnic Chinese PC patients who did and did not receive ADT. OBJECTIVE •  To examine the 5‐year risk of stroke among patients with prostate cancer (PC) receiving androgen deprivation therapy (ADT) in Taiwan, using a population‐based dataset. PATIENTS AND METHODS •  This prospective case–control study used data sourced from the Longitudinal Health Insurance Database. •  The study included 365 patients with PC; 64 (17.6%) received ADT for more than 1 month. •  Cox proportional hazards regression was used to evaluate the association between ADT and the risk of stroke during the subsequent 5‐year follow‐up period, after adjusting for sociodemographic characteristics and hypertension, diabetes, coronary heart disease, heart failure, atrial fibrillation and hyperlipidaemia. RESULTS •  In the total sample of 365 patients with PC, 68 (18.6%) patients had strokes during the 5‐year follow‐up period. These included 11 patients with PC who received ADT (17.2% of all patients who received ADT) and 57 patients who did not receive ADT (18.9% of patients who did not receive ADT). •  After adjusting for potential confounders, no significant difference in the hazard of stroke was found between patients with PC who did and did not receive ADT (hazard ratio, 1.09; 95% confidence interval, 0.80–1.50). CONCLUSION •  There was no significant difference in the risk of stroke between ethnic Chinese patients with PC who did and did not receive ADT, after adjusting for potential confounders.