Cardiovascular mortality by cancer risk stratification in patients with localized prostate cancer: a SEER-based study

Abstract

PurposeThe risk of cardiovascular disease (CVD) mortality in patients with localized prostate cancer (PCa) by risk stratification remains unclear. The aim of this study was to determine the risk of CVD death in patients with localized PCa by risk stratification.Patients and methodsPopulation-based study of 340,806 cases in the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with localized PCa between 2004 and 2016. The proportion of deaths identifies the primary cause of death, the competing risk model identifies the interaction between CVD and PCa, and the standardized mortality rate (SMR) quantifies the risk of CVD death in patients with PCa.ResultsCVD-related death was the leading cause of death in patients with localized PCa, and cumulative CVD-related death also surpassed PCa almost as soon as PCa was diagnosed in the low- and intermediate-risk groups. However, in the high-risk group, CVD surpassed PCa approximately 90 months later. Patients with localized PCa have a higher risk of CVD-related death compared to the general population and the risk increases steadily with survival (SMR = 4.8, 95% CI 4.6–5.1 to SMR = 13.6, 95% CI 12.8–14.5).ConclusionsCVD-related death is a major competing risk in patients with localized PCa, and cumulative CVD mortality increases steadily with survival time and exceeds PCa in all three stratifications (low, intermediate, and high risk). Patients with localized PCa have a higher CVD-related death than the general population. Management of patients with localized PCa requires attention to both the primary cancer and CVD.

Flare phenomenon visualized by 99mTc-bone scintigraphy has prognostic value for patients with metastatic castration-resistant prostate cancer

“…The rate of prostate cancer-caused deaths was essentially equal in both groups. Anti-cancer therapy is a main factor that increases the risk of non-prostate cancer-related deaths [ 19 – 21 ]. This led us to speculate whether the flare phenomenon not only indicates a better response, but also suggests better individual tolerance of toxicity caused by therapy.…”

Health Literacy, Individual and Community Engagement, and Cardiovascular Risks and Disparities

“… 3 Despite its generally favorable prognosis, men diagnosed with prostate cancer face a 4.5-fold increased risk of non–cancer-related mortality compared with mortality directly attributable to cancer itself. CVD emerges as the leading cause of death in prostate cancer survivors, 7 , 53 with a 36% higher mortality rate from CVD compared with the general population. Beyond mortality, two-thirds of men diagnosed with prostate cancer are at an increased risk of CVD.…”