Marco Moschini1,2,3, Emanuele Zaffuto1,4, Pierre Karakiewicz4, Agostino Mattei3, Giorgio Gandaglia1, Nicola Fossati1, Francesco Montorsi1, Alberto Briganti1, Shahrokh F Shariat5,6,7,8. 1. Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy. 2. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. 3. Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland. 4. Department of Urology, University of Montreal, Montreal, QC, Canada. 5. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. sfshariat@gmail.com. 6. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. sfshariat@gmail.com. 7. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA. sfshariat@gmail.com. 8. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. sfshariat@gmail.com.
Abstract
INTRODUCTION: Bladder cancer (BCa) is three-to-four times more common in men than in women. To explain this gender gap, several theories have been proposed, including the impact of androgen hormones. The aim of this study was to investigate the differential impact of androgen deprivation therapy (ADT) on subsequent risk of developing BCa in men with prostate cancer (PCa). METHODS: A total of 196,914 patients diagnosed with histologically confirmed localized PCa between 2000 and 2009 were identified in the SEER-Medicare insurance program-linked database. Competing-risk regression analyses were performed to assess the risk of developing BCa adjusting for the risk of all-cause mortality. Univariable and multivariable competing-risk regression analyses were performed to test the effect of ADT on BCa incidence for each PCa treatment modality. RESULTS: Of the 196,914 individuals included in the study, 68,421 (34.7%) received ADT. Median (IQR) follow-up was 59 (29-95) months. Overall, a total of 2495 (1.3%) individuals developed BCa during follow-up. After stratification according to ADT, the 10-year cumulative incidence rate was 1.75% (95% CI 1.65-1.85). In the untreated group, the 10-year cumulative incidence rate was 1.99% (95% CI 1.83-2.15). In multivariable competing-risk regression, the use of ADT was not associated with BCa, after accounting for the risk of dying from any cause (p = 0.1). CONCLUSION: We failed to identify any impact of ADT on the risk of developing a subsequent BCa even after stratifying according to the type of treatment. Further studies are required to explain the gender gap in BCa incidence and outcomes.
INTRODUCTION:Bladder cancer (BCa) is three-to-four times more common in men than in women. To explain this gender gap, several theories have been proposed, including the impact of androgen hormones. The aim of this study was to investigate the differential impact of androgen deprivation therapy (ADT) on subsequent risk of developing BCa in men with prostate cancer (PCa). METHODS: A total of 196,914 patients diagnosed with histologically confirmed localized PCa between 2000 and 2009 were identified in the SEER-Medicare insurance program-linked database. Competing-risk regression analyses were performed to assess the risk of developing BCa adjusting for the risk of all-cause mortality. Univariable and multivariable competing-risk regression analyses were performed to test the effect of ADT on BCa incidence for each PCa treatment modality. RESULTS: Of the 196,914 individuals included in the study, 68,421 (34.7%) received ADT. Median (IQR) follow-up was 59 (29-95) months. Overall, a total of 2495 (1.3%) individuals developed BCa during follow-up. After stratification according to ADT, the 10-year cumulative incidence rate was 1.75% (95% CI 1.65-1.85). In the untreated group, the 10-year cumulative incidence rate was 1.99% (95% CI 1.83-2.15). In multivariable competing-risk regression, the use of ADT was not associated with BCa, after accounting for the risk of dying from any cause (p = 0.1). CONCLUSION: We failed to identify any impact of ADT on the risk of developing a subsequent BCa even after stratifying according to the type of treatment. Further studies are required to explain the gender gap in BCa incidence and outcomes.
Authors: Carmen Mir; Shahrokh F Shariat; Theodorus H van der Kwast; Raheela Ashfaq; Yair Lotan; Andrew Evans; Sean Skeldon; Sally Hanna; Rati Vajpeyi; Cynthia Kuk; Sultan Alkhateeb; Juan Morote; Bas W G van Rhijn; Peter Bostrom; Jorge Yao; Hiroshi Miyamoto; Michael Jewett; Neil Fleshner; Ed Messing; Alexandre R Zlotta Journal: BJU Int Date: 2010-11-10 Impact factor: 5.588
Authors: Luis A Kluth; Malte Rieken; Evanguelos Xylinas; Matthew Kent; Michael Rink; Morgan Rouprêt; Nasim Sharifi; Asha Jamzadeh; Wassim Kassouf; Dharam Kaushik; Stephen A Boorjian; Florian Roghmann; Joachim Noldus; Alexandra Masson-Lecomte; Dimitri Vordos; Masaomi Ikeda; Kazumasa Matsumoto; Masayuki Hagiwara; Eiji Kikuchi; Yves Fradet; Jonathan Izawa; Ricardo Rendon; Adrian Fairey; Yair Lotan; Alexander Bachmann; Marc Zerbib; Margit Fisch; Douglas S Scherr; Andrew Vickers; Shahrokh F Shariat Journal: Eur Urol Date: 2013-12-05 Impact factor: 20.096
Authors: Harun Fajkovic; Joshua A Halpern; Eugene K Cha; Atessa Bahadori; Thomas F Chromecki; Pierre I Karakiewicz; Eckart Breinl; Axel S Merseburger; Shahrokh F Shariat Journal: World J Urol Date: 2011-06-09 Impact factor: 4.226