Androgen Deprivation Therapy for Prostate Cancer Did Not Increase the Risk of Retinal Vascular Occlusion: A Population-Based Cohort Study

This study aimed to evaluate the effect of androgen deprivation therapy (ADT) on retinal vascular occlusion (RVO) development in patients with prostate cancer, using data from Taiwan’s National Health Insurance Research Database. A total of 1791, 1791, and 3582 patients were enrolled in the prostate cancer with ADT group, prostate cancer without ADT group, and the control group, respectively. The primary outcome was RVO occurrence, according to diagnostic codes. Cox proportional hazard regression was used to determine the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of ADT and other covariates for RVO incidence. After a follow-up interval of up to 18 years, the patients with prostate cancer who received ADT showed significantly lower RVO incidence than the control group (aHR: 0.191, 95% CI: 0.059–0.621, p = 0.0059), after adjusting for multiple confounders. Hypertension was related to higher RVO incidence (aHR: 2.130, 95% CI: 1.127–4.027, p = 0.0199). Our overall results showed that using ADT for prostate cancer did not lead to a greater risk of RVO development. In fact, the patients with prostate cancer who received ADT had lower RVO incidence than those who did not receive ADT.

[1]  A. Jemal,et al.  Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries , 2021, CA: a cancer journal for clinicians.

[2]  K. Liao,et al.  Risk of ischemic stroke in patients with prostate cancer receiving androgen deprivation therapy in Taiwan , 2019, BMC Cancer.

[3]  B. Vanderbeek,et al.  TESTOSTERONE SUPPLEMENTATION AND RETINAL VASCULAR DISEASE , 2017, Retina.

[4]  P. Nguyen,et al.  Association of Androgen Deprivation Therapy and Thromboembolic Events: A Systematic Review and Meta-analysis. , 2018, Urology.

[5]  M. Othman,et al.  Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study. , 2017, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[6]  C. Ng,et al.  Risk of acute myocardial infarction after androgen‐deprivation therapy for prostate cancer in a Chinese population , 2015, BJU international.

[7]  C. Ng,et al.  Risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population living in Hong Kong. , 2015, Japanese journal of clinical oncology.

[8]  M. Guescini,et al.  Effects of sex hormones on inflammatory response in male and female vascular endothelial cells , 2014, Journal of Endocrinological Investigation.

[9]  D. Kuban,et al.  Addition of short-term androgen deprivation therapy to dose-escalated radiation therapy improves failure-free survival for select men with intermediate-risk prostate cancer. , 2012 .

[10]  Herng‐Ching Lin,et al.  Hormone therapy for prostate cancer and the risk of stroke: a 5‐year follow‐up study , 2012, BJU international.

[11]  Jim C Hu,et al.  Association of androgen deprivation therapy with cardiovascular death in patients with prostate cancer: a meta-analysis of randomized trials. , 2011, JAMA.

[12]  J. Boivin,et al.  Androgen-deprivation therapy and the risk of stroke in patients with prostate cancer. , 2011, European urology.

[13]  C. Chen,et al.  Vascular risk factors for central retinal artery occlusion , 2010, Eye.

[14]  J. Ray,et al.  Retinal vein occlusion and traditional risk factors for atherosclerosis. , 2008, Archives of ophthalmology.

[15]  A. D'Amico,et al.  Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. , 2007, Journal of the National Cancer Institute.

[16]  S. Hayreh Prevalent misconceptions about acute retinal vascular occlusive disorders , 2005, Progress in Retinal and Eye Research.

[17]  David Handelsman,et al.  Dihydrotestosterone promotes vascular cell adhesion molecule-1 expression in male human endothelial cells via a nuclear factor-kappaB-dependent pathway. , 2004, Endocrinology.

[18]  C. Higano Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. , 2003, Urology.

[19]  Hong Zhao,et al.  Effects of testosterone and 17-beta-estradiol on TNF-alpha-induced E-selectin and VCAM-1 expression in endothelial cells. Analysis of the underlying receptor pathways. , 2002, Life sciences.

[20]  I. Toda,et al.  Identification of androgen receptor protein and 5α-reductase mRNA in human ocular tissues , 2000, The British journal of ophthalmology.

[21]  M. Piérart,et al.  Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. , 1997, The New England journal of medicine.

[22]  G. Weir,et al.  Vascular disease. , 1991, Critical care nursing clinics of North America.

[23]  A. Lanthier,et al.  In vitro steroid metabolism by rat retina , 1988, Brain Research.