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Associations between Peripheral Thromboembolic Vascular Disease and Androgen Deprivation Therapy in Asian Prostate Cancer Patients

  • Lu, Yu-Chuan1, 2
  • Huang, Chao-Yuan2
  • Yeh, Huei-Ming3
  • Hong, Jian-Hua1, 2
  • Chang, Chao-Hsiang4, 5
  • Muo, Chih-Hsin6
  • Chung, Shiu-Dong7, 8
  • Yang, Teng-Kai9
  • Jaw, Fu-Shan1
  • Chung, Chi-Jung10, 11
  • 1 National Taiwan University, Institute of Biomedical Engineering, Taipei, Taiwan , Taipei (Taiwan)
  • 2 National Taiwan University Hospital, Department of Urology, Taipei, Taiwan , Taipei (Taiwan)
  • 3 National Taiwan University Hospital, Department of Anesthesiology, Taipei, Taiwan , Taipei (Taiwan)
  • 4 China Medical University and Hospital, Department of Urology, Taichung, Taiwan , Taichung (Taiwan)
  • 5 College of Medicine, China Medical University and Hospital, Department of Medicine, Taichung, Taiwan , Taichung (Taiwan)
  • 6 China Medical University and Hospital, Management Office for Health Data, Taichung, Taiwan , Taichung (Taiwan)
  • 7 Far Eastern Memorial Hospital, Division of Urology, Department of Surgery, New Taipei City, Taiwan , New Taipei City (Taiwan)
  • 8 College of Informatics, Yuan-Ze University, Graduate Program in Biomedical Informatics, Chung-Li, Taiwan , Chung-Li (Taiwan)
  • 9 Yonghe Cardinal Hospital, Surgery Department, New Taipei City, Taiwan , New Taipei City (Taiwan)
  • 10 China Medical University, Department of Public Health, Taichung, Taiwan , Taichung (Taiwan)
  • 11 China Medical University Hospital, Department of Medical Research, Taichung, Taiwan , Taichung (Taiwan)
Published Article
Scientific Reports
Springer Nature
Publication Date
Oct 02, 2019
DOI: 10.1038/s41598-019-50522-4
Springer Nature


This study aimed to investigate the risks of thromboembolic vascular disease following androgen deprivation therapy (ADT) administered to prostate cancer (PCa) patients. A total of 24,464 men with newly diagnosed PCa during 2000–2008 were recruited through a longitudinal health insurance database in Taiwan. All PCa patients were stratified into two: ADT and non-ADT groups. Patients with ADT treatment were grouped into three: surgical castration, chemical castration, and anti-androgen alone. The risks of pulmonary embolism (PE), peripheral arterial occlusion disease (PAOD), and deep vein thrombosis (DVT) were assessed in multiple Cox proportional-hazards regression with time-dependent covariates. During the 12-year follow-up period, incidence rates per 1000 person-years in ADT and non-ADT groups were 2.87 and 1.62 for DVT, 1.00 and 0.52 for PE, and 1.03 and 0.70 for PAOD, respectively. The DVT and PE risks were significantly increased in patients receiving combined androgen blockade (CAB) compared with the counterpart ADT non-recipients. After adjusting for potential risk factors, PCa patients receiving CAB had the highest PE risk (HR = 3.11), followed by DVT risk (HR = 2.53). The DVT risk remained elevated throughout the entire duration of chemical castration. However, high PE risk was observed in patients with ≤720-day treatment duration. No association was found between ADT and PAOD risks. Overall, the risks of PE and DVT were considerably heightened in Asian men subjected to CAB for PCa, whereas PAOD risk was unrelated to such treatments.

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