Osteoporosis and prostate cancer: a cross-sectional study of Danish men with prostate cancer before androgen deprivation therapy

Poulsen, Mads Hvid; Frost, Morten; Abrahamsen, Bo; Brixen, Kim; Walter, Steen

doi:10.3109/21681805.2014.884160

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…The study group consisted of 88 patients with prostate cancer awaiting initiation of androgen‐deprivation therapy (ADT) due to metastases (bone, lymph nodes, or both). The patients had been participating in two studies at Odense University Hospital, and they had undergone WBS as part of their evaluations . Relevant blood sample results were available and traditional staging had been performed.…”

Section: Methodsmentioning

confidence: 99%

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

et al. 2015

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ObjectiveTo evaluate the Bone Scan Index (BSI) for prediction of castration resistance and prostate cancer-specific survival (PCSS). In this retrospective study, we used novel computerassisted software for automated detection/quantification of bone metastases by BSI. Patients with prostate cancer are M-staged by whole-body bone scintigraphy (WBS) and categorised as M0 or M1. Within the M1 group, there is a wide range of clinical outcomes. The BSI was introduced a decade ago providing quantification of bone metastases by estimating the percentage of bone involvement. Being too time consuming, it never gained widespread clinical use. Patients and MethodsIn all, 88 patients with prostate cancer awaiting initiation of androgen-deprivation therapy due to metastases were included. WBS was performed using a two-headed c-camera. BSI was obtained using the automated platform EXINI bone (EXINI Diagnostics AB, Lund, Sweden). In Cox proportional hazard models, time to castration-resistant prostate cancer (CRPC) and PCSS were modelled as the dependent variables, whereas prostate-specific antigen (PSA) level, Gleason score and BSI were used as explanatory factors. For Kaplan-Meier estimates, BSI groups were dichotomously split into: BSI <1 and BSI ≥1. Discrimination between prognostic models was explored using the concordance index (C-index). ResultsThe mean (range) age of the patients was 72 (52-92) years, the median (range) PSA level was 73 (4-5 740) ng/mL, the mean (range) Gleason score was 7.7 (2-10), and the mean (range) BSI was 1.0 (0-9.2). During a mean (range) follow-up of 26 (8-49) months, 48 patients became castration resistant and 15 had died; most (13) ConclusionBSI obtained using a novel automated computer-assisted algorithm appears to be a useful predictor of outcome for time to CRPC and PCSS in patients with hormone-sensitive metastatic prostate cancer.

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Section: Methodsmentioning

confidence: 99%

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

et al. 2015

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“…Compared to controls, we found no significant differences of bone markers (OPG, OC, DPD) at baseline in primary PCa patients, instead we observed a higher prevalence of osteoporosis (33.3-53.3%) and lower spine and hip T scores. Recent studies have observed a comparable osteoporosis prevalence of up to 33-38% in hormone-naive PCa patients [29,30], suggesting further awareness of poor bone health in PCa patients and screening DXA scans prior to ADT, a recommendation which we find suitable for modern preventive medicine standards.…”

Section: Intra-group Comparisonmentioning

confidence: 84%

“…5 ♦2018 1100 with osteoporotic fractures [28] will significantly reduce the survival of PCa patients. Interestingly, there are reports that osteoporosis is more prevalent among non-metastatic PCa patients even before ADT [29,30], which suggests an imbalance between the coupling between bone formation and resorption as a possible secondary trait of PCa in the absence of external hormonal interventions. Therefore, the first objective of this study was to evaluate bone metabolism in primary PCa patients prior to any treatment intervention (surgical or pharmacological).…”

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confidence: 99%

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

Bojincă¹,

Popescu²,

Bălănescu³

et al. 2018

Rev. Chim.

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The objectives of the study were to evaluate bone metabolism in primary prostate cancer (PCa) patients prior to any treatment and to compare estrogens and anti-androgens in terms of bone metabolism. The study prospectively included consecutive patients with primary PCa who were proposed for radical prostatectomy and androgen deprivation therapy (ADT; either estrogens-group E, or anti-androgens -group A) and age-matched controls. Bone markers (osteoprotegerin -OPG; osteocalcin; deoxypyridinoline) were measured before treatment and after 6 months. Bone mineral density (BMD) was measured by dual X-ray absorptiometry before treatment and after 12 months (osteoporosis was defined as a spine or hip T score � -2.5). Continuous variables are reported as mean � standard deviation. The study included 30 controls (aged 70 � 6 years), 15 patients treated with estrogens (aged 71 � 6 years) and 15 patients with anti-androgens (aged 72 � 5 years). At baseline, 0% of controls, 33.3% of group E (p = 0.002 versus controls) and 53.3% of group A (p = 0.0001 versus controls) had osteoporosis. In group E, compared to baseline, OPG (4.67 � 1.38 versus 5.27 � 1.89; p = 0.043) and DPD (6.85 � 3.24 versus 8.63 � 2.42; p = 0.008) increased, while spine (0.99 � 0.32 versus 0.94 � 0.31; p = 0.019) BMD decreased. In group A, compared to baseline, OPG (6.37 � 3.04 versus 5.02 � 1.12; p = 0.041), spine (1.03 � 0.15 versus 0.89 � 0.15; p = 0.0003) and hip (0.82 � 0.18 versus 0.75 � 0.17; p = 0.003) BMD decreased. Osteoporosis is prevalent among hormone-na�ve PCa patients. Estrogens are associated with an increase of serum OPG, while anti-androgens with a decrease of serum OPG. Irrespective of ADT type, BMD still decreases in primary PCa patients.

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“…Bone health is another concern in ADT, as the treatment is known to increase susceptibility to osteoporosis. A multivariate analysis of PC patients demonstrated that smoking before ADT was significantly correlated with secondary osteoporosis in PC patients (odds ratio 1.037, 95% CI 1.011-1.065) [37].…”

Section: Treatment-related Outcomesmentioning

confidence: 99%

Adverse Health Outcomes Associated with Postdiagnosis Smoking in Prostate Cancer Patients: A Literature Review

Ganesh

Zaki

Chan

et al. 2017

Journal of Medical Imaging and Radiation Sciences

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Osteoporosis and prostate cancer: a cross-sectional study of Danish men with prostate cancer before androgen deprivation therapy

Abstract: Two-thirds of patients with prostate cancer awaiting ADT had osteoporosis or reduced bone mass. Further awareness regarding osteoporosis and bone health in prostate cancer is needed. It is suggested that patients with prostate cancer undergo a DXA scan before starting ADT.

Cited by 9 publications

References 33 publications

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

Adverse Health Outcomes Associated with Postdiagnosis Smoking in Prostate Cancer Patients: A Literature Review

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