Effect of osteoporotic fractures on overall survival in patients with non-metastatic prostatic cancer having androgen deprivation therapy

Abstract

INTRODUCTION AND OBJECTIVES: Patients with prostatic cancer who received androgen deprivation therapy (ADT) have high risk of developing osteoporosis with prevalence as high as 80% after 10 years of ADT. These patients have higher risk in developing osteoporotic fracture, which may result in significant morbidity and mortality. We study the correlations of incidence of osteoporotic fractures on overall survival in patients with non-metastatic prostatic cancer receiving ADT. METHODS: We retrospectively reviewed the records of 118 patients with non-metastatic prostatic cancer who received ADT in terms of bilateral simple orchidectomy or luteinizing hormone releasing hormone analogue (LHRHa) injection from 2006-2011. Demographics, evidence of bone metastasis, incidence of osteoporotic fracture and overall mortality were analysed. RESULTS: Of the 118 patients, 63 underwent bilateral orchidectomy and 50 received LHRHa. 5 patients initially on LHRHa subsequently underwent bilateral simple orchidectomy. 88 had bone scan to confirm the absence of bone metastasis, with the rest showed no clinical evidence of bone metastases. The median follow-up was 32 months. Group 1 included 106 patients without fractures, and Group 2 included 12 patients who developed osteoporotic fractures, in which 3 were vertebral fractures and 9 were hip fractures. The two groups were demographically similar, with median age 77.5 vs. 74.2, p=0.4. The median survival of patients of Group 1 and 2 was 26 months (1-82 months) and 40 months (15-86 months) respectively. There is no statistically difference in overall survival of these two groups of patients (p=0.679). CONCLUSIONS: Osteoporotic fractures in non-metastatic prostatic cancer patients on ADT are not associated with the overall survival. Prevention of osteoporotic fractures may improve patientÕs quality of life and decrease morbidity but does not affect overall survival.