Agent Orange and long-term outcomes after radical prostatectomy

Aaron E. Ovadia, Martha K. Terris, William J. Aronson, Christopher J. Kane, Christopher L. Amling, Matthew R. Cooperberg, Stephen J. Freedland, Michael R. Abern

Research output: Contribution to journalArticle

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Abstract

To investigate the association between Agent Orange (AO) exposure and long-term prostate cancer (PC) outcomes. Material and Methods: Data from 1,882 men undergoing radical prostatectomy for PC between 1988 and 2011 at Veterans Affairs Health Care Facilities were analyzed from the Shared Equal Access Regional Cancer Hospital database. Men were stratified by AO exposure (binary). Associations between AO exposure and biopsy and pathologic Gleason sum (GS) and pathologic stage were determined by logistic regression models adjusted for preoperative characteristics. Hazard ratios for biochemical recurrence (BCR), secondary treatment, metastases, and PC-specific mortality were determined by Cox models adjusted for preoperative characteristics. Results: There were 333 (17.7%) men with AO exposure. AO-exposed men were younger (median 59 vs. 62y), had lower preoperative prostate-specific antigen levels (5.8 vs. 6.7ng/ml), lower clinical category (25% vs. 38% palpable), and higher body mass index (28.2 vs. 27.6kg/m2), all P<0.01. Biopsy GS, pathologic GS, positive surgical margins, lymph node positivity, and extracapsular extension did not differ with AO exposure. At a median follow-up of 85 months, 702 (37.4%) patients had BCR, 603 (32.2%) patients received secondary treatment, 78 (4.1%) had metastases, and 39 (2.1%) died of PC. On multivariable analysis, AO exposure was not associated with BCR, secondary treatment, metastases, or PC mortality. Conclusions: AO exposure was not associated with worse preoperative characteristics such as elevated prostate-specific antigen levels or biopsy GS nor with BCR, secondary treatment, metastases, or PC death. Thus, as data on AO-exposed men mature, possible differences in PC outcomes observed previously are no longer apparent.

Original languageEnglish (US)
Pages (from-to)329.e1-329.e6
JournalUrologic Oncology: Seminars and Original Investigations
Volume33
Issue number7
DOIs
StatePublished - Jul 1 2015

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Prostatectomy
Prostatic Neoplasms
Neoplasm Metastasis
Recurrence
Prostate-Specific Antigen
Biopsy
Logistic Models
Veterans Health
Agent Orange
Cancer Care Facilities
Mortality
Health Facilities
Therapeutics
Proportional Hazards Models
Body Mass Index
Lymph Nodes
Databases
Delivery of Health Care

Keywords

  • Agent Orange
  • Prostate cancer
  • Prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Ovadia, A. E., Terris, M. K., Aronson, W. J., Kane, C. J., Amling, C. L., Cooperberg, M. R., ... Abern, M. R. (2015). Agent Orange and long-term outcomes after radical prostatectomy. Urologic Oncology: Seminars and Original Investigations, 33(7), 329.e1-329.e6. https://doi.org/10.1016/j.urolonc.2015.04.012

Agent Orange and long-term outcomes after radical prostatectomy. / Ovadia, Aaron E.; Terris, Martha K.; Aronson, William J.; Kane, Christopher J.; Amling, Christopher L.; Cooperberg, Matthew R.; Freedland, Stephen J.; Abern, Michael R.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 33, No. 7, 01.07.2015, p. 329.e1-329.e6.

Research output: Contribution to journalArticle

Ovadia, AE, Terris, MK, Aronson, WJ, Kane, CJ, Amling, CL, Cooperberg, MR, Freedland, SJ & Abern, MR 2015, 'Agent Orange and long-term outcomes after radical prostatectomy', Urologic Oncology: Seminars and Original Investigations, vol. 33, no. 7, pp. 329.e1-329.e6. https://doi.org/10.1016/j.urolonc.2015.04.012
Ovadia, Aaron E. ; Terris, Martha K. ; Aronson, William J. ; Kane, Christopher J. ; Amling, Christopher L. ; Cooperberg, Matthew R. ; Freedland, Stephen J. ; Abern, Michael R. / Agent Orange and long-term outcomes after radical prostatectomy. In: Urologic Oncology: Seminars and Original Investigations. 2015 ; Vol. 33, No. 7. pp. 329.e1-329.e6.
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abstract = "To investigate the association between Agent Orange (AO) exposure and long-term prostate cancer (PC) outcomes. Material and Methods: Data from 1,882 men undergoing radical prostatectomy for PC between 1988 and 2011 at Veterans Affairs Health Care Facilities were analyzed from the Shared Equal Access Regional Cancer Hospital database. Men were stratified by AO exposure (binary). Associations between AO exposure and biopsy and pathologic Gleason sum (GS) and pathologic stage were determined by logistic regression models adjusted for preoperative characteristics. Hazard ratios for biochemical recurrence (BCR), secondary treatment, metastases, and PC-specific mortality were determined by Cox models adjusted for preoperative characteristics. Results: There were 333 (17.7{\%}) men with AO exposure. AO-exposed men were younger (median 59 vs. 62y), had lower preoperative prostate-specific antigen levels (5.8 vs. 6.7ng/ml), lower clinical category (25{\%} vs. 38{\%} palpable), and higher body mass index (28.2 vs. 27.6kg/m2), all P<0.01. Biopsy GS, pathologic GS, positive surgical margins, lymph node positivity, and extracapsular extension did not differ with AO exposure. At a median follow-up of 85 months, 702 (37.4{\%}) patients had BCR, 603 (32.2{\%}) patients received secondary treatment, 78 (4.1{\%}) had metastases, and 39 (2.1{\%}) died of PC. On multivariable analysis, AO exposure was not associated with BCR, secondary treatment, metastases, or PC mortality. Conclusions: AO exposure was not associated with worse preoperative characteristics such as elevated prostate-specific antigen levels or biopsy GS nor with BCR, secondary treatment, metastases, or PC death. Thus, as data on AO-exposed men mature, possible differences in PC outcomes observed previously are no longer apparent.",
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AU - Cooperberg, Matthew R.

AU - Freedland, Stephen J.

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N2 - To investigate the association between Agent Orange (AO) exposure and long-term prostate cancer (PC) outcomes. Material and Methods: Data from 1,882 men undergoing radical prostatectomy for PC between 1988 and 2011 at Veterans Affairs Health Care Facilities were analyzed from the Shared Equal Access Regional Cancer Hospital database. Men were stratified by AO exposure (binary). Associations between AO exposure and biopsy and pathologic Gleason sum (GS) and pathologic stage were determined by logistic regression models adjusted for preoperative characteristics. Hazard ratios for biochemical recurrence (BCR), secondary treatment, metastases, and PC-specific mortality were determined by Cox models adjusted for preoperative characteristics. Results: There were 333 (17.7%) men with AO exposure. AO-exposed men were younger (median 59 vs. 62y), had lower preoperative prostate-specific antigen levels (5.8 vs. 6.7ng/ml), lower clinical category (25% vs. 38% palpable), and higher body mass index (28.2 vs. 27.6kg/m2), all P<0.01. Biopsy GS, pathologic GS, positive surgical margins, lymph node positivity, and extracapsular extension did not differ with AO exposure. At a median follow-up of 85 months, 702 (37.4%) patients had BCR, 603 (32.2%) patients received secondary treatment, 78 (4.1%) had metastases, and 39 (2.1%) died of PC. On multivariable analysis, AO exposure was not associated with BCR, secondary treatment, metastases, or PC mortality. Conclusions: AO exposure was not associated with worse preoperative characteristics such as elevated prostate-specific antigen levels or biopsy GS nor with BCR, secondary treatment, metastases, or PC death. Thus, as data on AO-exposed men mature, possible differences in PC outcomes observed previously are no longer apparent.

AB - To investigate the association between Agent Orange (AO) exposure and long-term prostate cancer (PC) outcomes. Material and Methods: Data from 1,882 men undergoing radical prostatectomy for PC between 1988 and 2011 at Veterans Affairs Health Care Facilities were analyzed from the Shared Equal Access Regional Cancer Hospital database. Men were stratified by AO exposure (binary). Associations between AO exposure and biopsy and pathologic Gleason sum (GS) and pathologic stage were determined by logistic regression models adjusted for preoperative characteristics. Hazard ratios for biochemical recurrence (BCR), secondary treatment, metastases, and PC-specific mortality were determined by Cox models adjusted for preoperative characteristics. Results: There were 333 (17.7%) men with AO exposure. AO-exposed men were younger (median 59 vs. 62y), had lower preoperative prostate-specific antigen levels (5.8 vs. 6.7ng/ml), lower clinical category (25% vs. 38% palpable), and higher body mass index (28.2 vs. 27.6kg/m2), all P<0.01. Biopsy GS, pathologic GS, positive surgical margins, lymph node positivity, and extracapsular extension did not differ with AO exposure. At a median follow-up of 85 months, 702 (37.4%) patients had BCR, 603 (32.2%) patients received secondary treatment, 78 (4.1%) had metastases, and 39 (2.1%) died of PC. On multivariable analysis, AO exposure was not associated with BCR, secondary treatment, metastases, or PC mortality. Conclusions: AO exposure was not associated with worse preoperative characteristics such as elevated prostate-specific antigen levels or biopsy GS nor with BCR, secondary treatment, metastases, or PC death. Thus, as data on AO-exposed men mature, possible differences in PC outcomes observed previously are no longer apparent.

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