Skeletal fracture associated with androgen suppression induced osteoporosis: the clinical incidence and risk factors for patients with prostate cancer.
OBJECTIVE
Limited information exists regarding the long-term risk of skeletal fracture in men on androgen suppression for prostate cancer. In addition, the clinical risk factors predisposing them to skeletal fracture are incompletely defined. We define the long-term risk and clinical risk factors for skeletal fracture in patients with prostate cancer on chronic androgen suppression.


METHODS
A total of 181 consecutive patients with prostate cancer on androgen suppression therapy were evaluated. The primary end point was skeletal fracture. Comprehensive demographic information was gathered, and univariate and multivariate analyses were performed to identify associations with skeletal fracture.


RESULTS
The proportion of patients who had survived fracture-free at 5 and 10 years on androgen suppression therapy was 96% and 80%, respectively. The black race (p = 0.009) and increased body mass index (p = 0.024) were identified as protective against androgen suppression associated skeletal fractures. A significant correlation was identified between the duration of androgen suppression and risk of skeletal fracture (p = 0.003).


CONCLUSIONS
Patients with prostate cancer treated with androgen suppression are at risk for skeletal fracture, and risk increases with the duration of therapy. Slender white men are at greatest risk. Conversely, black men and those with body mass indexes greater than normal (greater than 25 kg/m(2)) are at minimal risk despite a prolonged duration (10 years) of androgen suppression.
Oefelein
M G
MG
Department of Urology, University Hospital of Cleveland and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Ricchuiti
V
V
Conrad
W
W
Seftel
A
A
Bodner
D
D
Goldman
H
H
Resnick
M
M
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000209:etiology*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000139:chemically induced*; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy*; D012307:Risk Factors
D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone