First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality: results from SEARCH

Kagan Griffin, Ilona Csizmadi, Lauren E. Howard, Gina Maria Pomann, William J. Aronson, Christopher J. Kane, Christopher L. Amling, Matthew R. Cooperberg, Martha Kennedy Terris, Jennifer Beebe-Dimmer, Stephen J. Freedland

Research output: Contribution to journalArticle

Abstract

Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.

Original languageEnglish (US)
Pages (from-to)259-269
Number of pages11
JournalCancer Causes and Control
Volume30
Issue number3
DOIs
StatePublished - Mar 15 2019

Fingerprint

Cancer Care Facilities
Androgens
Weight Loss
Prostatic Neoplasms
Confidence Intervals
Mortality
Castration
Prostatectomy
Neoplasm Metastasis
Weight Gain
Therapeutics
Weights and Measures
Proportional Hazards Models

Keywords

  • Androgen-deprivation therapy
  • Metastases
  • Prostate cancer
  • Prostate cancer-specific mortality
  • Weight gain
  • Weight loss

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality : results from SEARCH. / Griffin, Kagan; Csizmadi, Ilona; Howard, Lauren E.; Pomann, Gina Maria; Aronson, William J.; Kane, Christopher J.; Amling, Christopher L.; Cooperberg, Matthew R.; Terris, Martha Kennedy; Beebe-Dimmer, Jennifer; Freedland, Stephen J.

In: Cancer Causes and Control, Vol. 30, No. 3, 15.03.2019, p. 259-269.

Research output: Contribution to journalArticle

Griffin, K, Csizmadi, I, Howard, LE, Pomann, GM, Aronson, WJ, Kane, CJ, Amling, CL, Cooperberg, MR, Terris, MK, Beebe-Dimmer, J & Freedland, SJ 2019, 'First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality: results from SEARCH', Cancer Causes and Control, vol. 30, no. 3, pp. 259-269. https://doi.org/10.1007/s10552-019-1133-5
Griffin, Kagan ; Csizmadi, Ilona ; Howard, Lauren E. ; Pomann, Gina Maria ; Aronson, William J. ; Kane, Christopher J. ; Amling, Christopher L. ; Cooperberg, Matthew R. ; Terris, Martha Kennedy ; Beebe-Dimmer, Jennifer ; Freedland, Stephen J. / First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality : results from SEARCH. In: Cancer Causes and Control. 2019 ; Vol. 30, No. 3. pp. 259-269.
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abstract = "Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95{\%} confidence intervals (95{\%} CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95{\%} CI 1.40–6.97), PCSM (HR 4.73; 95{\%} CI 1.59–14.0), and ACM (HR 2.16; 95{\%} CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95{\%} CI 0.73–3.42), CRPC (HR 1.33; 95{\%} CI 0.66–2.66), and PCSM (HR 2.44; 95{\%} CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.",
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T2 - results from SEARCH

AU - Griffin, Kagan

AU - Csizmadi, Ilona

AU - Howard, Lauren E.

AU - Pomann, Gina Maria

AU - Aronson, William J.

AU - Kane, Christopher J.

AU - Amling, Christopher L.

AU - Cooperberg, Matthew R.

AU - Terris, Martha Kennedy

AU - Beebe-Dimmer, Jennifer

AU - Freedland, Stephen J.

PY - 2019/3/15

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N2 - Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.

AB - Purpose: We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP). Methods: Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT. Results: During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant. Conclusions: Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.

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KW - Metastases

KW - Prostate cancer

KW - Prostate cancer-specific mortality

KW - Weight gain

KW - Weight loss

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