Evidence map›Paper›PMID 30988408›Full record

Observational studyProstate cancer and prostatic diseases2019

Stroke and thromboembolic events in men with prostate cancer treated with definitive radiation therapy with or without androgen deprivation therapy.

Rishi Deka, Daniel R Simpson, Matthew S Panizzon, Richard L Hauger, Paul Riviere, Vinit Nalawade, Rana McKay, James D Murphy, Brent S Rose

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Prostate cancer and prostatic diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Rishi DekaVA San Diego Health Care System, La Jolla, CA, USA. rdeka@ucsd.edu.
Daniel R SimpsonVA San Diego Health Care System, La Jolla, CA, USA.
Matthew S PanizzonCenter of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.
Richard L HaugerVA San Diego Health Care System, La Jolla, CA, USA.
Paul RiviereVA San Diego Health Care System, La Jolla, CA, USA.
Vinit NalawadeVA San Diego Health Care System, La Jolla, CA, USA.
Rana McKayVA San Diego Health Care System, La Jolla, CA, USA.
James D MurphyVA San Diego Health Care System, La Jolla, CA, USA.
Brent S RoseVA San Diego Health Care System, La Jolla, CA, USA.ORCID http://orcid.org/0000-0002-3197-9552
UC San Diego Health System · USUniversity of California San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is conflicting evidence regarding the association between androgen deprivation therapy (ADT) for prostate cancer (PC) and the risk of developing stroke and thromboembolic events. Our study evaluated the association between ADT use and development of stroke, transient ischemic attack (TIA), deep vein thrombosis (DVT), and pulmonary embolism (PE) in a homogenous group of men with PC treated with definitive radiation therapy (RT) after controlling for multiple sources of confounding.

methodsObservational cohort study of patients diagnosed with PC at the US Department of Veterans Affairs between 1 January 2001 and October 31, 2015 and treated with definitive RT. Exposure was initiation of ADT within 1 year of PC diagnosis. Primary outcomes were development of stroke, TIA, DVT, or PE.

results44,246 men with median follow-up of 6.8 years. The overall cumulative incidences of stroke, TIA, DVT, and PE at 10 years were 6.0, 3.0, 3.4, and 1.9%, respectively. In the multivariable competing risks model, there was a significant association between ADT and stroke (subdistribution hazard ratio (SHR) = 1.19, 95% CI = 1.09-1.30, p < 0.01), TIA (SHR = 1.24, 95% CI = 1.08-1.41, p < 0.01), and DVT (SHR = 1.18, 95% CI = 1.04-1.34, p < 0.01). ADT was only associated with PE in men receiving ADT for > 1 year (SHR = 1.34, 95% CI = 1.06-1.69, p-value = 0.03).

conclusionWe observed an increase in the risk of stroke, TIA, and DVT in men receiving ADT and an increased risk of PE in men receiving long-term ADT. These results highlight concerns regarding long-term risks of ADT on stroke and thromboembolic events in the treatment of PC.

Indexed as

AgedAged, 80 and overAndrogen AntagonistsChemoradiotherapyConfounding Factors, EpidemiologicFollow-Up StudiesHumansIncidenceMaleMiddle AgedProportional Hazards ModelsProstatic NeoplasmsStrokeThromboembolismTime FactorsUnited StatesAndrogen Antagonists

Identifiers

PMID30988408
OpenAlexW2939763596

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.