Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer: Analysis of community-based multi-institutional database across Japan using propensity score matching

Mizuki Onozawa, Hideyuki Akaza, Shiro Hinotsu, Mototsugu Oya, Osamu Ogawa, Tadaichi Kitamura, Kazuhiro Suzuki, Seiji Naito, Mikio Namiki, Kazuo Nishimura, Yoshihiko Hirao, Taiji Tsukamoto

研究成果: Article

2 引用 (Scopus)

抄録

Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were started on ADT by surgical or medical castration alone (monotherapy group, 5395 cases) or ADT in combination with a nonsteroidal anti-androgen (combined androgen blockade (CAB) group, 8379 cases). We used logistic regression analysis with background factors as independent factors to calculate propensity scores in regard to selection of CAB. Next, for 8826 cases of propensity score-matched patients, we compared the survival rates in the two groups. Results: The CAB group showed a significantly better progression-free survival (PFS) rate (65.6% vs 59.6% at 5 years; median time to progression, 11.6 vs 7.1 years; hazard ratio in the CAB group: 0.78, with a 95% confidence interval of 0.72 to 0.84; P < 0.001). In subgroup analysis based on the background factors, the PFS rate was generally better in the CAB group in all risk subgroups except for those having significant risk factors. Conclusion: Propensity score matching analysis revealed the prolongation of PFS by CAB in prostate cancer patients without significant risk factors. It would possible to decide the type of the first-line ADT according to the prostate cancer risk.

元の言語English
ジャーナルCancer Medicine
DOI
出版物ステータスAccepted/In press - 2018 1 1

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Propensity Score
Androgens
Prostatic Neoplasms
Japan
Databases
Therapeutics
Disease-Free Survival
Survival Rate
Castration
Nonsteroidal Anti-Androgens
Logistic Models
Regression Analysis
Confidence Intervals

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

これを引用

Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer : Analysis of community-based multi-institutional database across Japan using propensity score matching. / Onozawa, Mizuki; Akaza, Hideyuki; Hinotsu, Shiro; Oya, Mototsugu; Ogawa, Osamu; Kitamura, Tadaichi; Suzuki, Kazuhiro; Naito, Seiji; Namiki, Mikio; Nishimura, Kazuo; Hirao, Yoshihiko; Tsukamoto, Taiji.

:: Cancer Medicine, 01.01.2018.

研究成果: Article

Onozawa, Mizuki ; Akaza, Hideyuki ; Hinotsu, Shiro ; Oya, Mototsugu ; Ogawa, Osamu ; Kitamura, Tadaichi ; Suzuki, Kazuhiro ; Naito, Seiji ; Namiki, Mikio ; Nishimura, Kazuo ; Hirao, Yoshihiko ; Tsukamoto, Taiji. / Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer : Analysis of community-based multi-institutional database across Japan using propensity score matching. :: Cancer Medicine. 2018.
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title = "Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer: Analysis of community-based multi-institutional database across Japan using propensity score matching",
abstract = "Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were started on ADT by surgical or medical castration alone (monotherapy group, 5395 cases) or ADT in combination with a nonsteroidal anti-androgen (combined androgen blockade (CAB) group, 8379 cases). We used logistic regression analysis with background factors as independent factors to calculate propensity scores in regard to selection of CAB. Next, for 8826 cases of propensity score-matched patients, we compared the survival rates in the two groups. Results: The CAB group showed a significantly better progression-free survival (PFS) rate (65.6{\%} vs 59.6{\%} at 5 years; median time to progression, 11.6 vs 7.1 years; hazard ratio in the CAB group: 0.78, with a 95{\%} confidence interval of 0.72 to 0.84; P < 0.001). In subgroup analysis based on the background factors, the PFS rate was generally better in the CAB group in all risk subgroups except for those having significant risk factors. Conclusion: Propensity score matching analysis revealed the prolongation of PFS by CAB in prostate cancer patients without significant risk factors. It would possible to decide the type of the first-line ADT according to the prostate cancer risk.",
keywords = "castration-resistant, disease-free survival, hormone-sensitive, nonsteroidal anti-androgens, propensity score, prostatic neoplasms",
author = "Mizuki Onozawa and Hideyuki Akaza and Shiro Hinotsu and Mototsugu Oya and Osamu Ogawa and Tadaichi Kitamura and Kazuhiro Suzuki and Seiji Naito and Mikio Namiki and Kazuo Nishimura and Yoshihiko Hirao and Taiji Tsukamoto",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/cam4.1735",
language = "English",
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TY - JOUR

T1 - Combined androgen blockade achieved better oncological outcome in androgen deprivation therapy for prostate cancer

T2 - Analysis of community-based multi-institutional database across Japan using propensity score matching

AU - Onozawa, Mizuki

AU - Akaza, Hideyuki

AU - Hinotsu, Shiro

AU - Oya, Mototsugu

AU - Ogawa, Osamu

AU - Kitamura, Tadaichi

AU - Suzuki, Kazuhiro

AU - Naito, Seiji

AU - Namiki, Mikio

AU - Nishimura, Kazuo

AU - Hirao, Yoshihiko

AU - Tsukamoto, Taiji

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were started on ADT by surgical or medical castration alone (monotherapy group, 5395 cases) or ADT in combination with a nonsteroidal anti-androgen (combined androgen blockade (CAB) group, 8379 cases). We used logistic regression analysis with background factors as independent factors to calculate propensity scores in regard to selection of CAB. Next, for 8826 cases of propensity score-matched patients, we compared the survival rates in the two groups. Results: The CAB group showed a significantly better progression-free survival (PFS) rate (65.6% vs 59.6% at 5 years; median time to progression, 11.6 vs 7.1 years; hazard ratio in the CAB group: 0.78, with a 95% confidence interval of 0.72 to 0.84; P < 0.001). In subgroup analysis based on the background factors, the PFS rate was generally better in the CAB group in all risk subgroups except for those having significant risk factors. Conclusion: Propensity score matching analysis revealed the prolongation of PFS by CAB in prostate cancer patients without significant risk factors. It would possible to decide the type of the first-line ADT according to the prostate cancer risk.

AB - Background: This study investigated how differences in the method of the first-line androgen deprivation therapy (ADT) affected the time to castration-resistant prostate cancer. Methods: The Japan Study Group of Prostate Cancer compiled a nationwide community-based database on prostate cancer patients who underwent ADT. That database included 13 774 patients who were started on ADT by surgical or medical castration alone (monotherapy group, 5395 cases) or ADT in combination with a nonsteroidal anti-androgen (combined androgen blockade (CAB) group, 8379 cases). We used logistic regression analysis with background factors as independent factors to calculate propensity scores in regard to selection of CAB. Next, for 8826 cases of propensity score-matched patients, we compared the survival rates in the two groups. Results: The CAB group showed a significantly better progression-free survival (PFS) rate (65.6% vs 59.6% at 5 years; median time to progression, 11.6 vs 7.1 years; hazard ratio in the CAB group: 0.78, with a 95% confidence interval of 0.72 to 0.84; P < 0.001). In subgroup analysis based on the background factors, the PFS rate was generally better in the CAB group in all risk subgroups except for those having significant risk factors. Conclusion: Propensity score matching analysis revealed the prolongation of PFS by CAB in prostate cancer patients without significant risk factors. It would possible to decide the type of the first-line ADT according to the prostate cancer risk.

KW - castration-resistant

KW - disease-free survival

KW - hormone-sensitive

KW - nonsteroidal anti-androgens

KW - propensity score

KW - prostatic neoplasms

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U2 - 10.1002/cam4.1735

DO - 10.1002/cam4.1735

M3 - Article

C2 - 30151999

AN - SCOPUS:85052819293

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

ER -