Androgen deprivation therapy prevents bladder cancer recurrence
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Koji Izumi1, Masataka Taguri2, Hiroshi Miyamoto3, Yoshinori Hara4, Takeshi Kishida5, Kimio Chiba6, Tetsuo Murai7, Kotaro Hirai8, Kotaro Suzuki9, Kiyoshi Fujinami10, Teiichiro Ueki11, Koichi Udagawa12, Kazuo Kitami13, Masatoshi Moriyama14, Yasuhide Miyoshi15, Futoshi Tsuchiya16, Ichiro Ikeda17, Kazuki Kobayashi18, Maho Sato2, Satoshi Morita19, Kazumi Noguchi15, Hiroji Uemura1
1Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
2Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan
3Departments of Pathology and Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
4Department of Urology, Odawara Municipal Hospital, Odawara, Japan
5Department of Urology, Kanagawa Cancer Center, Yokohama, Japan
6Department of Urology, Kawasaki Municipal Ida Hospital, Kawasaki, Japan
7Department of Urology, International Goodwill Hospital, Yokohama, Japan
8Department of Urology, Sagamihara National Hospital, Sagamihara, Japan
9Department of Urology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan
10Department of Urology, Chigasaki Municipal Hospital, Chigasaki, Japan
11Department of Urology, Japanese Red Cross Hadano Hospital, Hadano, Japan
12Department of Urology, Hiratsuka Kyousai Hospital, Hiratsuka, Japan
13Department of Urology, Fujisawa City Hospital, Fujisawa, Japan
14Department of Urology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan
15Department of Urology, Yokohama City University Medical Center, Yokohama, Japan
16Department of Urology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
17Department of Urology, Yokohama Minami Kyousai Hospital, Yokohama, Japan
18Department of Urology, Yokosuka Kyousai Hospital, Yokosuka, Japan
19Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
Hiroji Uemura, e-mail: [email protected]
Keywords: Bladder cancer, recurrence, androgen, androgen deprivation therapy
Received: November 05, 2014 Accepted: December 03, 2014 Published: December 24, 2014
Although accumulating preclinical evidence indicates the involvement of androgen receptor signals in bladder cancer (BC) development, its clinical relevance remains unclear. We aimed to evaluate the predictive role of androgen deprivation therapy (ADT) in BC recurrence in prostate cancer (PC) patients.
We retrospectively reviewed 20,328 patients with PC diagnosed during 1991–2013 and identified 239 (1.2%) men having primary BC. After excluding ineligible patients, 162 patients made up a final cohort.
With a median follow-up of 62 months, 38 (50%) of 76 control patients without ADT experienced BC recurrence, while 19 (22%) of 86 did in ADT group. Thus, patients having received ADT for their PC showed a significantly lower risk of BC recurrence (5-year actuarial recurrence-free survival: 76% v 40%; P < 0.001) and also had a significantly smaller number of recurrence episodes (5-year cumulative recurrence: 0.44 v 1.54; P < 0.001), compared to the control patients. A multivariable analysis revealed ADT as an independent prognosticator (hazard ratio, 0.29; 95% confidence interval, 0.17–0.49) for BC recurrence.
This is the first clinical study showing that ADT significantly reduces the risk of BC recurrence.
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