title: Androgen deprivation therapy, diabetes and poor physical performance status increase fracture risk in Chinese men treated for prostate cancer.
abstract: We investigated the fracture risk after androgen deprivation therapy (ADT) for prostate cancer in the Chinese population. All Chinese prostate cancer patients who were treated primarily by radical prostatectomy or radiotherapy, with or without further ADT, from year 2000 to 2009 were reviewed. We compared the fracture risk in patients who were given ADT (ADT group) with those who were not given any ADT (non-ADT group). Potential risk factors including age, diabetes mellitus, hypertension, hyperlipidemia, ischemic heart disease and performance status were reviewed. The fracture risk was analyzed with Kaplan-Meier and multivariate Cox regression analyses. Our cohort consisted of 200 patients in the non-ADT group and 252 patients in the ADT group. The ADT group was shown to have higher fracture risk (p = 0.036) upon Kaplan-Meier analysis. Upon multivariate Cox regression analyses, diabetes mellitus (HR 4.39, 95% CI 1.08-17.83, p = 0.039), poor performance status (HR 3.14, 95% CI 1.24-8.00, p = 0.016) and the use of ADT (HR 4.89, 95% CI 1.03-23.17, p = 0.045) were associated with increased fracture risk. In conclusion, the fracture risk should be considered while deciding on ADT in Chinese men, especially in diabetic patients with poor performance status.
authors.affiliation: a Division of Urology, Department of Surgery and.
authors.forename: Jeremy Yuen Chun
authors.initials: JY
authors.lastname: Teoh
authors.affiliation: a Division of Urology, Department of Surgery and.
authors.forename: Peter Ka Fung
authors.initials: PK
authors.lastname: Chiu
authors.affiliation: a Division of Urology, Department of Surgery and.
authors.forename: Samson Yun Sang
authors.initials: SY
authors.lastname: Chan
authors.affiliation: b Department of Clinical Oncology , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, Hong Kong , China .
authors.forename: Darren Ming Chun
authors.initials: DM
authors.lastname: Poon
authors.affiliation: c Division of Urology, Department of Surgery , North District Hospital , Hong Kong , China , and.
authors.forename: Ho-Yuen
authors.initials: HY
authors.lastname: Cheung
authors.affiliation: a Division of Urology, Department of Surgery and.
authors.forename: Simon See Ming
authors.initials: SS
authors.lastname: Hou
authors.affiliation: a Division of Urology, Department of Surgery and.|d SH Ho Urology Centre , Department of Surgery , The Chinese University of Hong Kong , Shatin, Hong Kong , China.
authors.forename: Chi-Fai
authors.initials: CF
authors.lastname: Ng
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D048909:Diabetes Complications; D050723:Fractures, Bone / Q000209:etiology*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010809:Physical Fitness / Q000502:physiology*; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000726:Androgen Antagonists
keywords: Androgen deprivation therapy; Chinese; fracture; prostate cancer