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. 2017 Aug 22;8(42):73087-73097.
doi: 10.18632/oncotarget.20391. eCollection 2017 Sep 22.

Discrepancies on the association between androgen deprivation therapy for prostate cancer and subsequent dementia: meta-analysis and meta-regression

Jae Heon Kim #  1   2 , Bora Lee #  3   4 , Deok Hyun Han  1 , Kyoung Jin Chung  1 , In Gab Jeong  1 , Benjamin I Chung  1
Affiliations

Discrepancies on the association between androgen deprivation therapy for prostate cancer and subsequent dementia: meta-analysis and meta-regression

Jae Heon Kim et al. Oncotarget. .

Abstract

Limited literature exists on the association between androgen deprivation therapy (ADT) for prostate cancer (PCa) and subsequent dementia and the study conclusions are in conflicts with one another. We searched several cohort databases from 1960 to 2017 for observational or prospective studies that reported on an association between ADT for PCa and subsequent dementia. A meta-analysis was performed to cumulatively determine the association between ADT and dementia including Alzheimer's disease using an incidence rate ratio (IRR), crude hazard ratio (HR), and adjusted HR. Seven studies were eligible for the meta-analysis, with the inclusion of a total of 90, 543 prostate cancer patients. The pooled overall IRR, crude HR, and adjusted HR were 1.78 [95% confidence interval (CI): 1.51-2.10)], 1.80 (95% CI: 1.05-3.10), and 1.59 (95% CI: 1.16-2.18), respectively. A meta-regression analysis showed that the crude HR was affected by both follow -up duration and lag time in the univariate model (p = < 0.001). However, IRR and adjusted HR were not affected by these moderators. The overall outcomes of IRR, crude HR, and adjusted HR were found to be balanced in the sensitivity analysis. A positive association was demonstrated between ADT and the subsequent incidence of dementia in this meta-analysis. Methodological difference including follow-up duration and the time lag could be related with the discrepancies.

Keywords: alzheimer’s disease; androgen deprivation therapy; dementia; prostate cancer.

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Conflict of interest statement

CONFLICTS OF INTEREST All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. A flow diagram of the study selection process and inclusion criteria used for the meta-analysis
Figure 2
Figure 2
A forest plot of the overall incidence rate ratio (A), crude hazard ratio (B) and adjusted hazard ratio (C). The black square signifies the weighted mean of each estimate. All data pertain to continuous outcomes.
Figure 3
Figure 3. A sensitivity analysis of the incidence rate ratio, crude hazard ratio, and adjusted hazard ratio
Figure 4
Figure 4
A meta-regression analysis of the incidence rate ratio (A), crude hazard ratio (B) and adjusted hazard ratio (C), using moderators of follow-up duration and lag time. The black square signifies the weighted mean of each estimate. All data pertain to continuous outcomes.
See this image and copyright information in PMC

References

    1. Kuykendal AR, Hendrix LH, Salloum RG, Godley PA, Chen RC. Guideline-discordant androgen deprivation therapy in localized prostate cancer: patterns of use in the medicare population and cost implications. Ann Oncol. 2013;24:1338–43. - PMC - PubMed
    1. Gupta M, McCauley J, Farkas A, Gudeloglu A, Neuberger MM, Ho YY, Yeung L, Vieweg J, Dahm P. Clinical practice guidelines on prostate cancer: a critical appraisal. J Urol. 2015;193:1153–8. - PubMed
    1. Wu FJ, Sheu SY, Lin HC, Chung SD. Increased Fall Risk in Patients Receiving Androgen Deprivation Therapy for Prostate Cancer. Urology. 2016;95:145–50. - PubMed
    1. Keating NL, O'Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24:4448–56. - PubMed
    1. Bosco C, Bosnyak Z, Malmberg A, Adolfsson J, Keating NL, Van Hemelrijck M. Quantifying observational evidence for risk of fatal and nonfatal cardiovascular disease following androgen deprivation therapy for prostate cancer: a meta-analysis. Eur Urol. 2015;68:386–96. - PubMed