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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Philip W. Kantoff,Celestia S. Higano,N. Shore,E. Roy Berger,Eric J. Small,David F. Penson,Charles H. Redfern,Anna C. Ferrari,Robert Dreicer,Robert B. Sims,Yi Xu,Mark W. Frohlich,Paul F. Schellhammer +12 more
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Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy for Prostate Cancer
TL;DR: GnRH agonist treatment for men with locoregional prostate cancer may be associated with an increased risk of incident diabetes and cardiovascular disease and the benefits of GnRH agonists should be weighed against these potential risks.
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Axel Heidenreich,Joaquim Bellmunt,Michel Bolla,Steven Joniau,Vsevolod Matveev,N. Mottet,Thomas Wiegel,Filiberto Zattoni +7 more
TL;DR: The introduction of an effective blood test, prostate specific antigen (PSA), has made it possible to diagnose more and more men in an earlier stage where they can be offered potentially curative treatments, and this is the subject of the EAU guidelines on prostate cancer.
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Combined Resistance and Aerobic Exercise Program Reverses Muscle Loss in Men Undergoing Androgen Suppression Therapy for Prostate Cancer Without Bone Metastases: A Randomized Controlled Trial
TL;DR: A relatively brief exposure to exercise significantly improved muscle mass, strength, physical function, and balance in hypogonadal men compared with normal care and could be recommended for patients undergoing AST as an effective countermeasure to these common treatment-related adverse effects.
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Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy: Observational Study of Veterans With Prostate Cancer
TL;DR: Androgen deprivation therapy with GnRH agonists was associated with an increased risk of diabetes and cardiovascular disease and oral antiandrogen monotherapy was not associated with any outcome studied.
References
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Journal Article
Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer. Discussion
Maxwell V. Meng,Gary D. Grossfeld,Natalia Sadetsky,Shilpa S. Mehta,Deborah P. Lubeck,Peter R. Carroll,Oliver Sartor,Alan Pollack,Anthony V. D'Amico,Philip W. Kantoff +9 more
TL;DR: The use of androgen deprivation therapy (ADT) is increasingly being used to treat lower stages of prostate cancer as discussed by the authors, and the appropriateness of such therapy requires further study, including its effect on disease endpoints, but also on resource utilization and health-related quality of life.
Journal ArticleDOI
Prostate cancer trends in the era of prostate-specific antigen: An update of incidence, mortality, and clinical factors from the SEER database
TL;DR: In this paper, the authors proposed a method to determine the time to death from prostate cancer versus when the patient would die from a competing cause, based on weak statistical speculation at the time of prostate cancer diagnosis.
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Agreement of Medicare claims and tumor registry data for assessment of cancer-related treatment.
TL;DR: Analysis of a database linking Surveillance, Epidemiology and End Results (SEER) registry data and Medicare claims in patients aged aged > or =65 years with cancer found Medicare files may be appropriate for studies of patterns of use of surgical treatment, but not for diagnostic procedures.
Journal ArticleDOI
The impact of androgen deprivation on quality of life after radical prostatectomy for prostate carcinoma
Floyd J. Fowler,Mary McNaughton Collins,Elizabeth Walker Corkery,Diana B. Elliott,Michael J. Barry +4 more
TL;DR: Measures of health‐related quality of life (HRQOL) in men who were treated with androgen deprivation after radical prostatectomy are compared with those for men who underwent surgery but were not treated withandrogen deprivation.
Journal ArticleDOI
A structured debate: immediate versus deferred androgen suppression in prostate cancer-evidence for deferred treatment.
TL;DR: It is shown that immediate hormonal intervention has not been conclusively shown to provide a survival advantage in the management of advanced prostate cancer, and delayed treatment is recommended in men with biochemical relapse following surgery or radiotherapy.