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Cognitive Impairment in Men with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis

2018; Lippincott Williams & Wilkins; Volume: 199; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2017.11.136

1527-3792

Maxine Sun, Alexander P. Cole, Nawar Hanna, Lorelei A. Mucci, Donna L. Berry, Shehzad Basaria, David K. Ahern, Adam S. Kibel, Toni K. Choueiri, Quoc‐Dien Trinh,

Breast Cancer Treatment Studies

No AccessJournal of UrologyReview Article1 Jun 2018Cognitive Impairment in Men with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis Maxine Sun, Alexander P. Cole, Nawar Hanna, Lorelei A. Mucci, Donna L. Berry, Shehzad Basaria, David K. Ahern, Adam S. Kibel, Toni K. Choueiri, and Quoc-Dien Trinh Maxine SunMaxine Sun Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Equal study contribution. More articles by this author , Alexander P. ColeAlexander P. Cole Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Equal study contribution. Supported by a grant from Brigham Research Institute. More articles by this author , Nawar HannaNawar Hanna Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Lorelei A. MucciLorelei A. Mucci Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts More articles by this author , Donna L. BerryDonna L. Berry Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author , Shehzad BasariaShehzad Basaria Research Program in Men’s Health: Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Department of Medicine, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Regeneron and AbbVie. More articles by this author , David K. AhernDavid K. Ahern Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Adam S. KibelAdam S. Kibel Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Toni K. ChoueiriToni K. Choueiri Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Astellas and Bayer. Supported by a grant from the Vattikuti Urology Institute, and awards from the Prostate Cancer Foundation and the Conquer Cancer Foundation of the American Society of Clinical Oncology. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.11.136AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Use of androgen deprivation therapy may increase the risk of cognitive impairment in men with prostate cancer. We performed a systematic review of the risk of overall cognitive impairment as an outcome in men receiving androgen deprivation therapy for prostate cancer. Materials and Methods: Studies were identified through PubMed®, MEDLINE®, PsycINFO®, Cochrane Library and Web of Knowledge/Science™. Articles were included if they 1) were published in English, 2) had subjects treated for prostate cancer with androgen deprivation therapy, 3) incorporated longitudinal comparisons and 4) used control groups. In addition, prospective studies were required to assess an established cognitive related end point using International Cognition and Cancer Task Force criteria defining impaired cognitive performance as scoring 1.5 or more standard deviations below published norms on 2 or more tests, or scoring 2.0 or more standard deviations below published norms on at least 1 test. The effect of androgen deprivation therapy on cognitive impairment was pooled using a random effects model. Results: Of 221 abstracts 26 were selected for full text review, and 2 prospective and 4 retrospective studies were analyzed. Androgen deprivation therapy was not associated with overall cognitive impairment when the prospective cohort studies were pooled (OR 1.57, 95% CI 0.50 to 4.92, p = 0.44) with significant heterogeneity between estimates (I2 = 83%). In retrospective data the relative risk of any cognitive impairment, including senile dementia and Alzheimer disease, was increased in men receiving androgen deprivation therapy, although the difference was not statistically significant (HR 1.28, 95% CI 0.93 to 1.76, p = 0.13) with moderate heterogeneity between estimates (I2 = 67%). Conclusions: Analyses between overall cognitive impairment and use of androgen deprivation therapy defined according to International Cognition and Cancer Task Force criteria in a pooled analysis were inconclusive. In retrospective cohort studies the risk of overall cognitive impairment after androgen deprivation therapy was not significant. Better prospective studies need to be designed for the assessment of this end point. References 1 : Studies on prostatic cancer. I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin1972; 22: 232. 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Google Scholar © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAlibhai S (2021) Editorial CommentJournal of Urology, VOL. 207, NO. 4, (840-840), Online publication date: 1-Apr-2022.Sari Motlagh R, Quhal F, Mori K, Miura N, Aydh A, Laukhtina E, Pradere B, Karakiewicz P, Enikeev D, Deuker M and Shariat S (2020) The Risk of New Onset Dementia and/or Alzheimer Disease among Patients with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 205, NO. 1, (60-67), Online publication date: 1-Jan-2021.Griebling T (2020) Re: Androgen Deprivation Therapy for Prostate Cancer and Risk of DementiaJournal of Urology, VOL. 204, NO. 5, (1076-1076), Online publication date: 1-Nov-2020.Gild P, Cole A, Krasnova A, Dickerman B, von Landenberg N, Sun M, Mucci L, Lipsitz S, Chun F, Nguyen P, Kibel A, Choueiri T, Basaria S and Trinh Q (2018) Liver Disease in Men Undergoing Androgen Deprivation Therapy for Prostate CancerJournal of Urology, VOL. 200, NO. 3, (573-581), Online publication date: 1-Sep-2018. Volume 199Issue 6June 2018Page: 1417-1425Supplementary Materials Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.Keywordsdementiacognitionprostatic neoplasmsAlzheimer diseaseandrogen antagonistsMetricsAuthor Information Maxine Sun Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Equal study contribution. More articles by this author Alexander P. Cole Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Equal study contribution. Supported by a grant from Brigham Research Institute. More articles by this author Nawar Hanna Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Lorelei A. Mucci Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts More articles by this author Donna L. Berry Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author Shehzad Basaria Research Program in Men’s Health: Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Department of Medicine, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Regeneron and AbbVie. More articles by this author David K. Ahern Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Adam S. Kibel Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Toni K. Choueiri Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts More articles by this author Quoc-Dien Trinh Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Astellas and Bayer. Supported by a grant from the Vattikuti Urology Institute, and awards from the Prostate Cancer Foundation and the Conquer Cancer Foundation of the American Society of Clinical Oncology. More articles by this author Expand All Advertisement PDF downloadLoading ...