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Urology
Research
Association between ischaemic bowel syndromes and androgen deprivation therapy in patients with prostate cancer: a retrospective cohort study
  1. I-Ni Chiang1,2,
  2. Chao-Yuan Huang2,
  3. Yeong-Shiau Pu2,
  4. Chao-Hsiang Chang3,4,
  5. Chih-Hsin Muo5,6,
  6. Chi-Jung Chung7,8,
  7. Ruey-Yun Wang5,
  8. Tai-Horng Young1
  1. 1Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
  2. 2Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  3. 3Department of Urology, China Medical University and Hospital, Taichung, Taiwan
  4. 4Department of Medicine, College of Medicine, China Medical University and Hospital, Taichung, Taiwan
  5. 5Department of Public Health, China Medical University, Taichung, Taiwan
  6. 6Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan
  7. 7Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan
  8. 8Department of Medical Research, China Medical University and Hospital, Taichung, Taiwan
  1. Correspondence to Professor Ruey-Yun Wang; rywang0812{at}gmail.com

Abstract

Objective This study investigated the risk of ischaemic bowel syndrome (IBS) in androgen deprivation therapy (ADT) users to explore the long-term outcomes of patients with prostate cancer (PC) receiving ADT treatment.

Methods We performed a population-based retrospective cohort study. All the clinical information of the study participants were acquired from the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. We extracted data for all the patients newly diagnosed with prostate malignancy (ICD-9-CM 185 or C61 in ICD-10-CM) from 2000 to 2008. The patients were then divided into two groups: 7160 male ADT cohort receiving ADT and 7160 male non-ADT comparison group frequency matched by age and index year of ADT treatment of the ADT group. Cox proportional hazard regression was used to estimate the adjusted HR and 95% CIs of the IBS risk.

Results No significant difference was noted in the overall incidence rate for IBS between the ADT and non-ADT cohorts (0.86 and 0.89 per 1000 person–year, respectively, p=0.89). Even after adjusting for potential risk factors, a 1.06-fold risk of IBS (95% CI 0.62 to 1.82, p=0.82) was observed in the ADT cohort relative to the non-ADT cohorts. Moreover, we stratified the ADT cohort by time point of ADT treatment after PC diagnosis. Different IBS incidence rates were observed among the early ADT, late-ADT and non-ADT users at 0.77, 1.23 and 0.89 per 1000 person-years, respectively; nonetheless, the difference was not statistically significant. Moreover, no difference was found between the ADT treatment types and IBS risk, including sole orchiectomy, sole luteinising-hormone-releasing hormone and both.

Conclusions Results showed that ADT treatment in patients with PC is not an independent factor for IBS incidence. Large sample sizes for patients with IBS with patients with PC who had received ADT treatment are needed for further study.

  • ischemic bowel syndrome
  • androgen deprivation therapy
  • prostate cancer

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-012950

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    Footnotes

    • Contributors C-JC, I-NC, C-YH, Y-SP, C-HC, R-YW and T-HY partly contributed to the conception and design of the work; C-JC, R-YW and C-HM contributed to the analysis of the data and wrote the manuscript; C-HM performed the data analysis. All authors have read the manuscript and approved the final version for submission to BMJ Open and those they accept responsibility for the manuscript's contents.

    • Funding This study is supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019); China Medical University Hospital; Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

    • Competing interests All authors have disclosed any potential competing financial interests regarding the submitted article.

    • Ethics approval This study was approved by the Research Ethics Committee of China Medical University and hospital (CMUH104-REC2-115).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.