Risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population living in Hong Kong.
OBJECTIVE
Previous reports on the risk of stroke after androgen deprivation therapy for prostate cancer were largely based on Caucasians. We investigated the risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population.


METHODS
All Chinese prostate cancer patients who were treated primarily with radical prostatectomy or radiotherapy, with (androgen deprivation therapy group) or without (non-androgen deprivation therapy group) further androgen deprivation therapy, at our hospital from year 2000-09 were reviewed. Potential risk factors of ischemic stroke including age, baseline prostate-specific antigen, Gleason score, clinical T stage, hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, history of stroke, use of androgen deprivation therapy and duration of androgen deprivation therapy were reviewed. The risk of ischemic stroke after androgen deprivation therapy was analyzed with Kaplan-Meier and multivariate Cox regression analyses.


RESULTS
A total of 452 patients were included, consisting of 200 patients in the non-androgen deprivation therapy group and 252 patients in the androgen deprivation therapy group. The androgen deprivation therapy group appeared to have increased risk of ischemic stroke when compared with the non-androgen deprivation therapy group (P = 0.063) upon Kaplan-Meier analysis. Upon multivariate Cox regression analyses, older age (hazard ratio 1.13, 95% confidence interval 1.04-1.22, P = 0.003), hyperlipidemia (hazard ratio 4.61, 95% confidence interval 2.01-10.54, P < 0.001) and the use of androgen deprivation therapy (hazard ratio 3.32, 95% confidence interval 1.14-9.67, P = 0.028) were associated with increased risk of ischemic stroke.


CONCLUSIONS
There was increased risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population. The risk of ischemic stroke should be considered while deciding on androgen deprivation therapy, especially in older patients with known history of hyperlipidemia.
['Teoh|Jeremy Yuen Chun|JY|', 'Chiu|Peter Ka Fung|PK|', 'Chan|Samson Yun Sang|SY|', 'Poon|Darren Ming Chun|DM|', 'Cheung|Ho Yuen|HY|', 'Hou|Simon See Ming|SS|', 'Ng|Chi-Fai|CF|']
D000368:Aged D000726:Androgen Antagonists D000970:Antineoplastic Agents D044466:Asians D014408:Biomarkers, Tumor D002545:Brain Ischemia D015897:Comorbidity D006723:Hong Kong D006801:Humans D006949:Hyperlipidemias D006973:Hypertension D015994:Incidence D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D060787:Neoplasm Grading D009367:Neoplasm Staging D016017:Odds Ratio D016016:Proportional Hazards Models D017430:Prostate-Specific Antigen D011468:Prostatectomy D011471:Prostatic Neoplasms D018570:Risk Assessment D012307:Risk Factors D020521:Stroke
stroke androgen deprivation therapy prostate cancer Chinese population