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Clinical Research

Bone complications among prostate cancer survivors: long-term follow-up from the prostate cancer outcomes study

Prostate Cancer and Prostatic Diseases volume 17, pages 338–342 (2014)Cite this article

Subjects

Abstract

Background:

To assess the relationship between androgen deprivation therapy (ADT) exposure and self-reported bone complications among men in a population-based cohort of prostate cancer survivors followed for 15 years after diagnosis.

Methods:

The Prostate Cancer Outcomes Study enrolled 3533 patients diagnosed with prostate cancer between 1994 and 1995. This analysis included participants with non-metastatic disease at the time of diagnosis who completed 15-year follow-up surveys to report development of fracture, and use of bone-related medications. The relationship between ADT duration and bone complications was assessed using multivariable logistic regression models.

Results:

Among 961 surviving men, 157 (16.3%) received prolonged ADT (>1 year), 120 (12.5%) received short-term ADT (⩽1 year) and 684 (71.2%) did not receive ADT. Men receiving prolonged ADT had higher odds of fracture (OR 2.5; 95% confidence interval (CI): 1.1–5.7), bone mineral density testing (OR 5.9; 95% CI: 3.0–12) and bone medication use (OR 4.3; 95% CI: 2.3–8.0) than untreated men. Men receiving short-term ADT reported rates of fracture similar to untreated men. Half of men treated with prolonged ADT reported bone medication use.

Conclusions:

In this population-based cohort study with long-term follow-up, prolonged ADT use was associated with substantial risks of fracture, whereas short-term use was not. This information should be considered when weighing the advantages and disadvantages of ADT in men with prostate cancer.

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Acknowledgements

This study was funded by support from the National Cancer Institute, National Institutes of Health, Bethesda, MD, Grant No. R01-CA114524 and the following contracts from the each of the participating institutions: N01-PC-67007, N01-PC-67009, N01-PC-67010, N01-PC-67006, N01-PC-67005 and N01-PC-67000.

Author information

Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA

    A K Morgans, K-H Fan, T Koyama & D F Penson

  2. Vanderbilt University Center for Quantitative Sciences and Department of Biostatistics, Nashville, TN, USA

    K-H Fan & T Koyama

  3. University of Connecticut Health Center, Farmington, CT, USA

    P C Albertsen

  4. Emory University, Atlanta, GA, USA

    M Goodman

  5. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    A S Hamilton

  6. University of New Mexico, Albuquerque, NM, USA

    R M Hoffman

  7. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    J L Stanford

  8. University of Utah, Salt Lake City, UT, USA

    A M Stroup

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  1. A K Morgans
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  2. K-H Fan
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  3. T Koyama
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  4. P C Albertsen
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  5. M Goodman
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  6. A S Hamilton
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  7. R M Hoffman
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  8. J L Stanford
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  9. A M Stroup
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  10. D F Penson
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Corresponding author

Correspondence to A K Morgans.

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Competing interests

PCA has a compensated advisory role at Ferring Corporation. The other authors declare no conflict of interest.

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Morgans, A., Fan, KH., Koyama, T. et al. Bone complications among prostate cancer survivors: long-term follow-up from the prostate cancer outcomes study. Prostate Cancer Prostatic Dis 17, 338–342 (2014). https://doi.org/10.1038/pcan.2014.31

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