Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma
TLDR
The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin‐releasing hormone (GnRH) agonists or orchiectomy, in population‐based tumor registries.Abstract:
BACKGROUND
The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, in population-based tumor registries.
METHODS
Data were obtained from the linked Surveillance, Epidemiology and End Results-Medicare database. A total of 100,274 men with prostate carcinoma diagnosed from 1991 through 1999 were selected. The main outcome was the proportion of men who received ≥ 1 dose of a GnRH agonist in the first 6 months of diagnosis. This was plotted by year and stratified for age, grade, stage as well as primary versus adjuvant usage. Multiple logistic regression was used to examine predictors of GnRH agonist use in the subset of patients with localized cancer.
RESULTS
There was a consistent increase in GnRH agonist use by year for all ages, stages, and grades. Even in men ≥ 80 years with localized stage and low to moderate grade tumors, primary GnRH agonist use increased over the study period, from 3.7% in 1991 to 30.9% in 1999 (P < 0.001). The multivariable analysis showed that significant variability in GnRH agonist use existed among SEER geographic regions.
CONCLUSIONS
The use of GnRH agonists for prostate carcinoma increased dramatically during the 1990s. This increase occurred across all stages and histologic grades of prostate carcinoma, and was greatest in patients ≥ 80 years. Cancer 2005. © 2005 American Cancer Society.read more
Citations
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Relationship between androgen deprivation therapy and community-acquired respiratory infections in patients with prostate cancer.
Marianne Schmid,Marianne Schmid,Julian Hanske,Julian Hanske,Praful Ravi,Nandita Krishna,Gally Reznor,Christian Meyer,Christian Meyer,Margit Fisch,Joachim Noldus,Paul L. Nguyen,Quoc-Dien Trinh +12 more
TL;DR: To investigate the dose‐dependent effect of androgen deprivation therapy on community‐acquired respiratory infections in patients with localized prostate cancer, data are presented on whether the therapy reduces the likelihood of future prostate cancer.
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Gonadotropin-releasing hormone agonist use in men without a cancer registry diagnosis of prostate cancer
TL;DR: Lack of a registry diagnosis of prostate cancer in GnRH agonist users was significantly more likely with increasing comorbidity, whereas it was less likely in men who had undergone either inpatient admission or procedures such as radical prostatectomy, prostate biopsy, or transurethral resection of the prostate.
References
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A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation☆
TL;DR: The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
Book
AJCC Cancer Staging Manual
Mahul B. Amin,Stephen B. Edge,Frederick L. Greene,David R. Byrd,Robert K. Brookland,Mary Kay Washington,Jeffrey E. Gershenwald,Carolyn C. Compton,Kenneth R. Hess,Daniel C. Sullivan,J. Milburn Jessup,James D. Brierley,Lauri E. Gaspar,Richard L. Schilsky,Charles M. Balch,David P. Winchester,Elliot A. Asare,Martin Madera,Donna M. Gress,Laura R. Meyer +19 more
TL;DR: Purposes and Principles of Cancer Staging and End-Results Reporting are explained.
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Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate
TL;DR: Gutman et al. as mentioned in this paper showed that the acid phosphatase of serum is reduced in metastatic carcinoma of the prostate by decreasing the activity of androgens through castration or estrogenic injections and that this enzyme is increased by injecting androgens.
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Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate
TL;DR: It is demonstrated that a marked rise in acid phosphatase in serum is associated with the appearance or spread of roentgenologically demonstrable skeletal metastases and implies dissemination of the primary tumor and thus is of unfavorable prognostic significance.