Bone management in Japanese patients with prostate cancer

Hormonal therapy leads to an increase in the FRAX score

Takashi Kawahara, Shusei Fusayasu, Koji Izumi, Yumiko Yokomizo, Hiroki Ito, Yusuke Ito, Kayo Kurita, Kazuhiro Furuya, Hisashi Hasumi, Narihiko Hayashi, Yasuhide Myoshi, Hiroshi Miyamoto, Masahiro Yao, Hiroji Uemura

Research output: Contribution to journalArticle

Abstract

Background: Osteoporosis is a common consequence of androgen deprivation therapy (ADT) for prostate cancer. Up to 20 % of men on ADT have suffered from fractures within 5 years. The WHO Fracture Risk Assessment Tool (FRAX) has been utilized to predict the 10-year probability of major osteoporotic and hip fracture. However, to date, no large studies assessing the utility of the FRAX score in prostate cancer patients with or without ADT have been performed. We herein evaluated the impact of ADT on the FRAX score in prostate cancer patients. Methods: The assessment of the FRAX score was performed in a total of 1220 prostate cancer patients, including patients who underwent brachytherapy (n = 547), radical prostatectomy (n = 200), external beam radiation therapy (n = 264) and hormonal therapy alone (n = 187) at Yokohama City University Hospital (Yokohama, Japan). We evaluated the effect of ADT on the FRAX score. Results: Using the FRAX model, the median and mean 10-year probability of a major osteoporotic fracture according to the clinical risk factors alone was 7.9 % (8.8 ± 4.3 %), while the 10-year probability of hip fracture risk was 2.7 % (3.5 ± 3.1 %). In the ADT group, the duration of ADT was correlated with both major osteoporotic risk and hip fracture risk (R2 = 0.141, p <0.001 and R2 = 0.166, p <0.001, respectively). A comparison between the ADT (n = 187) and non-ADT (n = 399) groups demonstrated that the major fracture risk was > 20 % higher and the hip fracture risk was > 3 % higher in the ADT group than in the non-ADT group (ADT: 10 (5.3 %) and 118 (63.1 %), non-ADT 13 (3.3 %) and 189 (47.4 %), p <0.001 and p <0.001, respectively). Conclusions: These results suggested that the longer duration of ADT led to an increased FRAX score, and the FRAX score may be a predictor of bone management treatment, particularly in prostate cancer patients.

Original languageEnglish (US)
Article number32
JournalBMC Urology
Volume16
Issue number1
DOIs
StatePublished - Jun 17 2016

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Prostatic Neoplasms
Androgens
Bone and Bones
Hip Fractures
Osteoporotic Fractures
Group Psychotherapy
Therapeutics
Urban Hospitals
Brachytherapy
Prostatectomy
Osteoporosis
Japan
Radiotherapy

Keywords

  • Androgen deprivation therapy
  • Bone fracture
  • FRAX
  • Prostate cancer

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Kawahara, T., Fusayasu, S., Izumi, K., Yokomizo, Y., Ito, H., Ito, Y., ... Uemura, H. (2016). Bone management in Japanese patients with prostate cancer: Hormonal therapy leads to an increase in the FRAX score. BMC Urology, 16(1), [32]. https://doi.org/10.1186/s12894-016-0151-9

Bone management in Japanese patients with prostate cancer : Hormonal therapy leads to an increase in the FRAX score. / Kawahara, Takashi; Fusayasu, Shusei; Izumi, Koji; Yokomizo, Yumiko; Ito, Hiroki; Ito, Yusuke; Kurita, Kayo; Furuya, Kazuhiro; Hasumi, Hisashi; Hayashi, Narihiko; Myoshi, Yasuhide; Miyamoto, Hiroshi; Yao, Masahiro; Uemura, Hiroji.

In: BMC Urology, Vol. 16, No. 1, 32, 17.06.2016.

Research output: Contribution to journalArticle

Kawahara, T, Fusayasu, S, Izumi, K, Yokomizo, Y, Ito, H, Ito, Y, Kurita, K, Furuya, K, Hasumi, H, Hayashi, N, Myoshi, Y, Miyamoto, H, Yao, M & Uemura, H 2016, 'Bone management in Japanese patients with prostate cancer: Hormonal therapy leads to an increase in the FRAX score', BMC Urology, vol. 16, no. 1, 32. https://doi.org/10.1186/s12894-016-0151-9
Kawahara, Takashi ; Fusayasu, Shusei ; Izumi, Koji ; Yokomizo, Yumiko ; Ito, Hiroki ; Ito, Yusuke ; Kurita, Kayo ; Furuya, Kazuhiro ; Hasumi, Hisashi ; Hayashi, Narihiko ; Myoshi, Yasuhide ; Miyamoto, Hiroshi ; Yao, Masahiro ; Uemura, Hiroji. / Bone management in Japanese patients with prostate cancer : Hormonal therapy leads to an increase in the FRAX score. In: BMC Urology. 2016 ; Vol. 16, No. 1.
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abstract = "Background: Osteoporosis is a common consequence of androgen deprivation therapy (ADT) for prostate cancer. Up to 20 {\%} of men on ADT have suffered from fractures within 5 years. The WHO Fracture Risk Assessment Tool (FRAX) has been utilized to predict the 10-year probability of major osteoporotic and hip fracture. However, to date, no large studies assessing the utility of the FRAX score in prostate cancer patients with or without ADT have been performed. We herein evaluated the impact of ADT on the FRAX score in prostate cancer patients. Methods: The assessment of the FRAX score was performed in a total of 1220 prostate cancer patients, including patients who underwent brachytherapy (n = 547), radical prostatectomy (n = 200), external beam radiation therapy (n = 264) and hormonal therapy alone (n = 187) at Yokohama City University Hospital (Yokohama, Japan). We evaluated the effect of ADT on the FRAX score. Results: Using the FRAX model, the median and mean 10-year probability of a major osteoporotic fracture according to the clinical risk factors alone was 7.9 {\%} (8.8 ± 4.3 {\%}), while the 10-year probability of hip fracture risk was 2.7 {\%} (3.5 ± 3.1 {\%}). In the ADT group, the duration of ADT was correlated with both major osteoporotic risk and hip fracture risk (R2 = 0.141, p <0.001 and R2 = 0.166, p <0.001, respectively). A comparison between the ADT (n = 187) and non-ADT (n = 399) groups demonstrated that the major fracture risk was > 20 {\%} higher and the hip fracture risk was > 3 {\%} higher in the ADT group than in the non-ADT group (ADT: 10 (5.3 {\%}) and 118 (63.1 {\%}), non-ADT 13 (3.3 {\%}) and 189 (47.4 {\%}), p <0.001 and p <0.001, respectively). Conclusions: These results suggested that the longer duration of ADT led to an increased FRAX score, and the FRAX score may be a predictor of bone management treatment, particularly in prostate cancer patients.",
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T1 - Bone management in Japanese patients with prostate cancer

T2 - Hormonal therapy leads to an increase in the FRAX score

AU - Kawahara, Takashi

AU - Fusayasu, Shusei

AU - Izumi, Koji

AU - Yokomizo, Yumiko

AU - Ito, Hiroki

AU - Ito, Yusuke

AU - Kurita, Kayo

AU - Furuya, Kazuhiro

AU - Hasumi, Hisashi

AU - Hayashi, Narihiko

AU - Myoshi, Yasuhide

AU - Miyamoto, Hiroshi

AU - Yao, Masahiro

AU - Uemura, Hiroji

PY - 2016/6/17

Y1 - 2016/6/17

N2 - Background: Osteoporosis is a common consequence of androgen deprivation therapy (ADT) for prostate cancer. Up to 20 % of men on ADT have suffered from fractures within 5 years. The WHO Fracture Risk Assessment Tool (FRAX) has been utilized to predict the 10-year probability of major osteoporotic and hip fracture. However, to date, no large studies assessing the utility of the FRAX score in prostate cancer patients with or without ADT have been performed. We herein evaluated the impact of ADT on the FRAX score in prostate cancer patients. Methods: The assessment of the FRAX score was performed in a total of 1220 prostate cancer patients, including patients who underwent brachytherapy (n = 547), radical prostatectomy (n = 200), external beam radiation therapy (n = 264) and hormonal therapy alone (n = 187) at Yokohama City University Hospital (Yokohama, Japan). We evaluated the effect of ADT on the FRAX score. Results: Using the FRAX model, the median and mean 10-year probability of a major osteoporotic fracture according to the clinical risk factors alone was 7.9 % (8.8 ± 4.3 %), while the 10-year probability of hip fracture risk was 2.7 % (3.5 ± 3.1 %). In the ADT group, the duration of ADT was correlated with both major osteoporotic risk and hip fracture risk (R2 = 0.141, p <0.001 and R2 = 0.166, p <0.001, respectively). A comparison between the ADT (n = 187) and non-ADT (n = 399) groups demonstrated that the major fracture risk was > 20 % higher and the hip fracture risk was > 3 % higher in the ADT group than in the non-ADT group (ADT: 10 (5.3 %) and 118 (63.1 %), non-ADT 13 (3.3 %) and 189 (47.4 %), p <0.001 and p <0.001, respectively). Conclusions: These results suggested that the longer duration of ADT led to an increased FRAX score, and the FRAX score may be a predictor of bone management treatment, particularly in prostate cancer patients.

AB - Background: Osteoporosis is a common consequence of androgen deprivation therapy (ADT) for prostate cancer. Up to 20 % of men on ADT have suffered from fractures within 5 years. The WHO Fracture Risk Assessment Tool (FRAX) has been utilized to predict the 10-year probability of major osteoporotic and hip fracture. However, to date, no large studies assessing the utility of the FRAX score in prostate cancer patients with or without ADT have been performed. We herein evaluated the impact of ADT on the FRAX score in prostate cancer patients. Methods: The assessment of the FRAX score was performed in a total of 1220 prostate cancer patients, including patients who underwent brachytherapy (n = 547), radical prostatectomy (n = 200), external beam radiation therapy (n = 264) and hormonal therapy alone (n = 187) at Yokohama City University Hospital (Yokohama, Japan). We evaluated the effect of ADT on the FRAX score. Results: Using the FRAX model, the median and mean 10-year probability of a major osteoporotic fracture according to the clinical risk factors alone was 7.9 % (8.8 ± 4.3 %), while the 10-year probability of hip fracture risk was 2.7 % (3.5 ± 3.1 %). In the ADT group, the duration of ADT was correlated with both major osteoporotic risk and hip fracture risk (R2 = 0.141, p <0.001 and R2 = 0.166, p <0.001, respectively). A comparison between the ADT (n = 187) and non-ADT (n = 399) groups demonstrated that the major fracture risk was > 20 % higher and the hip fracture risk was > 3 % higher in the ADT group than in the non-ADT group (ADT: 10 (5.3 %) and 118 (63.1 %), non-ADT 13 (3.3 %) and 189 (47.4 %), p <0.001 and p <0.001, respectively). Conclusions: These results suggested that the longer duration of ADT led to an increased FRAX score, and the FRAX score may be a predictor of bone management treatment, particularly in prostate cancer patients.

KW - Androgen deprivation therapy

KW - Bone fracture

KW - FRAX

KW - Prostate cancer

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