Study shows men who experience fracture following treatment have higher mortality risk
A recent study explored the impact of long-term androgen deprivation therapy (ADT) for prostate cancer on men with an already ‘high’ risk of bone fracture. According to the new research from The Cancer Institute of New Jersey, these men have a higher fracture incidence following ADT. The researchers also discovered that the mortality risk was 1.38-fold higher in men who experienced a fracture compared with those who did not.
Using the population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, the investigators reviewed the records of 75,994 men aged 66 and older who were diagnosed as having localized prostate cancer from 1992 to 2007. (The authors note the use of bisphosphonates and the patients’ height and weight were not available in the SEER-Medicare linked data.) Researchers developed a risk assessment scale for baseline skeletal complications, using the presence of certain conditions (including alcohol and cigarette use, diabetes, liver disease, and paralysis) within 1 year prior to cancer diagnosis.
The findings, published in the latest online version of BJU International, showed that during a 12-year follow-up, at least 1 fracture occurred following ADT in more than 58% of men deemed at high fracture risk prior to treatment and in 38% considered at low risk. Moreover, mortality risk was determined to be 40% higher within 2 years after experiencing a fracture.
According to study results, men with a high baseline risk had a 52.1% probability of receiving ADT. Those with a low baseline risk had a 38.2% likelihood of being given ADT. Furthermore, those men receiving ADT alone were likely to receive a stronger dose compared with men who received a combination prostate cancer therapy including ADT.
“Our findings suggest that treating men having a high baseline risk of fracture with long-term androgen deprivation therapy may have serious adverse consequences,” said senior author Grace Lu-Yao, PhD, MPH, cancer epidemiologist at The Cancer Institute of New Jersey and professor of medicine at Robert Wood Johnson Medical School and of epidemiology at the University of Medicine and Dentistry of New Jersey School of Public Health.
Source: The Cancer Institute of New Jersey.