Clinical and prognostic significance of changes in haemoglobin concentration during 1 year of androgen‐deprivation therapy for hormone‐naïve bone‐metastatic prostate cancer. (30th May 2018)

• Record Type: Journal Article
• Authors: Ebbinge, Maria; Berglund, Anders; Varenhorst, Eberhard; Hedlund, Per Olov; Sandblom, Gabriel
• Other Names: Krarup Torben investigator.; Hvidt Valdemar investigator.; Mogensen Peter investigator.; Luke Michael investigator.; Sørensen Ole investigator.; Frimodt‐Møller Cai investigator.; Willumsen Henrik investigator.; Klarskov Peter investigator.; Mortensen Svend investigator.; Rasmussen Finn investigator.; Andersen Jesper Rye investigator.; Rosenkilde Palle investigator.; Iversen Hans‐Georg investigator.; Larsen Erik investigator.; Skaarup Paul investigator.; Farber John investigator.; Melchior‐Nissen Hans investigator.; Mommsen Søren investigator.; Iversen Peter investigator.; Kristensen Jørgen Kvist investigator.; Wolf Hans investigator.; Lundbeck Finn investigator.; Højsgaard Arne investigator.; Halme Antero investigator.; Salo Jaakko investigator.; Ruutu Mirja investigator.; Kasinen Eero investigator.; Juusela Harri investigator.; Ala‐Opas Martti investigator.; Salminen Risto investigator.; Liukkonen Tapani investigator.; Viitanen Jouko investigator.; Talja Martti investigator.; Permi Jaakko investigator.; Puolakka Veli‐Matti investigator.; Nurmi Martti investigator.; Hansson Erkki investigator.; Geirsson Gudmundur investigator.; Höisaeter Per‐Aage investigator.; Haukaas Svein investigator.; Hesselberg Fredrik investigator.; Vada Karsten investigator.; Vaage Sigmund investigator.; Tasdemir Ilker investigator.; Lundmo Per investigator.; Ögreid Per investigator.; Ribbegren Carl‐Johan investigator.; Owczarski Andrzej investigator.; Lindeborg Torsten investigator.; Borck Leif investigator.; Susskind Stig investigator.; Hedberg Bo investigator.; Kihl Björn investigator.; Olsson Jan‐Olof investigator.; Häggarth Lars investigator.; Larsson Bruno investigator.; Lindberg Bengt investigator.; Carlsson Sture investigator.; Höjgaard Inge investigator.; Spångberg Anders investigator.; Elfving Peter investigator.; Lundgren Rolf investigator.; Hahne Bengt investigator.; Ideström Rickard investigator.; Hedelin Hans investigator.; Damber Jan‐Erik investigator.; Andersson Bengt investigator.; Sandin Torsten investigator.; Waldén Mauritz investigator.; Telhammar Ebbe investigator.; Olsson Ronnie investigator.; Granfors Torvald investigator.; Stattin Pär investigator.; Brekkan Einar investigator.; Norlen Bo Johan investigator.; Hammarsten Jan investigator.; Mikkelsen Ib investigator.; Ramsing Anders investigator.; Wall Inger investigator.; Adell Lars investigator.; Ullman Agneta investigator.; Nelson Curt‐Eric investigator.; Ljungeryd Susanne investigator.; Andersson Sven‐Olof investigator.; Johansson Jan Erik investigator.; Carlström Kjell investigator.; Damber Jan Erik investigator.; Henriksson Peter investigator.; Tammela Teuvo investigator.; Nielsen Ole Steen investigator.; Damber Lena investigator.; Pousette Åke investigator.; Rannikko Sakari investigator.; Stege Reinhard investigator.;
• Is Part Of: BJU international. Volume 122:Number 4(2018)
• Page Start: 583
• Page End: 591
• Publication Date: 2018-05-30
• Subjects: androgen deprivation treatment -- bone metastasis -- hormone‐naïve -- haemoglobin changes -- predictors of survival -- prostate cancer; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.14227
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objective: To estimate the strength of change in haemoglobin (Hb) concentrations during 1 year of androgen‐deprivation therapy (ADT) as a predictor of survival in hormone‐naïve patients with bone‐metastatic (Stage M1b) prostate cancer. Patients and Methods: The patients included in this study were taken from the randomised trial (number 5) carried out by the Scandinavian Prostate Cancer Group (SPCG), comparing parenteral oestrogen with total androgen blockade (TAB) in hormone‐naïve M1b prostate cancer. We identified 597 men where Hb measurements were made at enrolment, as well as at 3, 6 and 12 months of ADT. The time‐dependent impact of Hb concentration changes on overall survival (OS) was analysed using multivariate Cox proportional hazards analysis. The 10‐year OS according to increase/decrease in Hb concentration for the three treatment periods was demonstrated using Kaplan–Meier curves. Results: Multivariate analysis of changes in Hb concentration between baseline and 3 months showed better survival in patients with a decrease in Hb concentration (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.11–1.80) compared to those with an increase, whilst there was no difference in survival associated with a change in Hb concentration between 3 and 6 months (HR 0.93, 95% CI 0.76–1.12). Contrary to the first 3 months, poorer survival was seen in patients with a decrease in Hb concentration between 6 and 12 months (HR 0.76, 95% CI 0.62–0.92) compared to those with an increase. Conclusions: In a large cohort of Scandinavian men with hormone‐naïve M1b prostate cancer, an increase in Hb concentration between baseline and 3 months of ADT was associated with significantly poorer survival, whereas an increase between 6 and 12 months was associated with better survival. These findings provide new information about patterns of change in Hb concentrations during 12 months of ADT for M1b prostate cancer, and survival. Clinicians should be aware of the prognostic value of Hb concentration changes during ADT in M1b prostate cancer.