Cardiovascular outcomes after curative prostate cancer treatment: A population-based cohort study

被引：4

作者：

Kjellstadli, Camilla ^{[1
,2
]}

Forster, Rachel B. ^{[1
]}

Myklebust, Tor A. ^{[3
,4
]}

Bjorge, Tone ^{[5
,6
]}

Bonaa, Kaare H. ^{[7
,8
]}

Helle, Svein I. ^{[2
]}

Kvale, Rune ^{[1
,2
]}

机构：

[1] Norwegian Inst Publ Hlth, Dept Hlth Registry Res & Dev, Bergen, Norway

[2] Haukeland Hosp, Dept Oncol & Med Phys, Bergen, Norway

[3] Dept Registrat, Canc Registry Norway, Oslo, Norway

[4] More & Romsdal Hosp Trust, Dept Res & Innovat, Alesund, Norway

[5] Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway

[6] Canc Registry Norway, Sect Cerv Canc Screening, Oslo, Norway

[7] Trondheim Reg & Univ Hosp, St Olavs Hosp, Dept Cardiol, Trondheim, Norway

[8] Norwegian Univ Sci & Technol, Dept Circulat & Med Imaging, Trondheim, Norway

来源：

FRONTIERS IN ONCOLOGY | 2023年 / 13卷

关键词：

prostate cancer; radical prostatectomy; definitive radiotherapy; cardiovascular disease; curative treatment; epidemiology; registry; ANDROGEN DEPRIVATION THERAPY; RISK-FACTORS; DISEASE; MEN; ASSOCIATION; SURGERY;

D O I：

10.3389/fonc.2023.1121872

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

ObjectiveTo investigate differences in cardiovascular disease (CVD) morbidity and mortality after radical prostatectomy or definitive radiotherapy with or without androgen deprivation therapy (ADT). Materials and methodsWe used population-based data from the Cancer Registry of Norway, the Norwegian Patient Registry and the Norwegian Cause of Death Registry including 19 289 men <= 80 years diagnosed with non-metastatic prostate cancer during 2010-2019. Patients were treated with radical prostatectomy or definitive radiotherapy. We used competing risk models to compare morbidity from overall CVD, acute myocardial infarction (AMI), cerebral infarction, thromboembolism, and CVD-specific mortality for the overall cohort and stratified by prognostic risk groups. ResultsAfter a median follow-up time of 5.4 years (IQR 4.6 years), there were no differences in adjusted rates of AMI, cerebral infarction, and CVD-specific death between radical prostatectomy and definitive radiotherapy in any of the prognostic risk groups. Rates of overall CVD (0.82; 95% CI 0.76-0.89) and thromboembolism (0.30; 95% CI 0.20-0.44) were lower for definitive radiotherapy than radical prostatectomy during the first year of follow-up. After this overall CVD rates (1.19; 95% CI 1.11-1.28) were consistently higher across all risk groups in patients treated with definitive radiotherapy, but there were no differences regarding thromboembolism. ConclusionsDuring the first years after treatment, no differences were found in rates of AMI, cerebral infarction, and CVD-specific death between radiotherapy and radical prostatectomy in any of the prognostic risk groups. This suggests that ADT use in combination with radiotherapy may not increase the risks of these outcomes in a curative setting. The increased overall CVD rate for definitive radiotherapy after the first year indicates a possible relationship between definitive radiotherapy and other CVDs than AMI and cerebral infarction.

引用

页数：11

共 35 条

[1] Increased curative treatment is associated with decreased prostate cancer-specific and overall mortality in senior adults with high-risk prostate cancer; results from a national registry-based cohort study [J].