Yasuyuki Sakai1, Tetsuya Shindo2, Shunsuke Sato3, Atsushi Takahashi4, Yasuharu Kunishima5, Ryuichi Kato6, Naoki Itoh3, Manabu Okada7, Hitoshi Tachiki8, Keisuke Taguchi9, Akio Takayanagi10, Hiroshi Hotta11, Hiroki Horita12, Masanori Matsukawa13, Masahiro Matsuki14, Koyo Nishiyama15, Akihiro Miyazaki15, Kohei Hashimoto1, Toshiaki Tanaka1, Naoya Masumori1. 1. Departments of Urology, Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. 2. Department of Urology, Hakodate Goryoukaku Hospital, 38-3 Goryoukaku, Hakodate, 040-8611, Japan. shindo1013@yahoo.co.jp. 3. Department of Urology, NTT East Sapporo Hospital, Sapporo, Japan. 4. Department of Urology, Hakodate Goryoukaku Hospital, 38-3 Goryoukaku, Hakodate, 040-8611, Japan. 5. Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan. 6. Department of Urology, Muroran City General Hospital, Muroran, Japan. 7. Department of Urology, Obihiro Kyokai Hospital, Obihiro, Japan. 8. Department of Urology, Steel Memorial Muroran Center, Muroran, Japan. 9. Department of Urology, Oji General Hospital, Tomakomai, Japan. 10. Department of Urology, JCHO Hokkaido Hospital, Sapporo, Japan. 11. Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan. 12. Department of Urology, Hokkaido Saiseikai Otaru Hospital, Otaru, Japan. 13. Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan. 14. Department of Urology, Japanese Red Cross Kushiro Hospital, Kushiro, Japan. 15. Oral Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Abstract
INTRODUCTION: We evaluated the incidence and risk factors for antiresorptive agent-related osteonecrosis of the jaw (ARONJ) in prostate and kidney cancer patients. MATERIALS AND METHODS: We retrospectively reviewed the clinical data of 547 patients from 13 hospitals. Prostate and kidney cancer patients with bone metastases who were treated with a bone-modifying agent (BMA) between January 2012 and February 2019 were enrolled. Exclusion criteria were BMA use for hypercalcemia, a lack of clinical data, a follow-up period of less than 28 days and a lack of evaluation by dentists before BMA administration. The diagnosis and staging of ARONJ were done by dentists. RESULTS: Two-hundred eighteen patients were finally enrolled in the study, including 168 prostate cancer patients and 50 kidney cancer patients. Of them, 49 (29%) prostate cancer patients and 18 (36%) kidney cancer patients needed tooth extraction prior to BMA initiation. The mean follow-up period after BMA initiation was 552.9 ± 424.7 days (mean ± SD). In the cohort, 23% of the patients were diagnosed with ARONJ in the follow-up period. The 1-year cumulative incidences of ARONJ were 9.4% and 15.4% in prostate and kidney cancer patients, respectively. Multivariate analysis indicated that kidney cancer, tooth extraction before BMA and a body mass index (BMI) ≥ 25 kg/m2 were significant predictors for ARONJ. CONCLUSION: ARONJ is not a rare adverse event in urological malignancies. Especially, kidney cancer, high BMI patients and who needed tooth extraction before BMA were high risk for developing ARONJ.
INTRODUCTION: We evaluated the incidence and risk factors for antiresorptive agent-related osteonecrosis of the jaw (ARONJ) in prostate and kidney cancerpatients. MATERIALS AND METHODS: We retrospectively reviewed the clinical data of 547 patients from 13 hospitals. Prostate and kidney cancerpatients with bone metastases who were treated with a bone-modifying agent (BMA) between January 2012 and February 2019 were enrolled. Exclusion criteria were BMA use for hypercalcemia, a lack of clinical data, a follow-up period of less than 28 days and a lack of evaluation by dentists before BMA administration. The diagnosis and staging of ARONJ were done by dentists. RESULTS: Two-hundred eighteen patients were finally enrolled in the study, including 168 prostate cancerpatients and 50 kidney cancerpatients. Of them, 49 (29%) prostate cancerpatients and 18 (36%) kidney cancerpatients needed tooth extraction prior to BMA initiation. The mean follow-up period after BMA initiation was 552.9 ± 424.7 days (mean ± SD). In the cohort, 23% of the patients were diagnosed with ARONJ in the follow-up period. The 1-year cumulative incidences of ARONJ were 9.4% and 15.4% in prostate and kidney cancerpatients, respectively. Multivariate analysis indicated that kidney cancer, tooth extraction before BMA and a body mass index (BMI) ≥ 25 kg/m2 were significant predictors for ARONJ. CONCLUSION: ARONJ is not a rare adverse event in urological malignancies. Especially, kidney cancer, high BMI patients and who needed tooth extraction before BMA were high risk for developing ARONJ.
Entities:
Keywords:
Denosumab; Kidney cancer; Osteonecrosis of the jaw; Prostate cancer; Zoledronic acid