Suppressed Recurrent Bladder Cancer after Androgen Suppression with Androgen Deprivation Therapy or 5α-Reductase Inhibitor

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• 作者：Masaki Shiota ; ^{shiota@uro.med.kyushu-u.ac.jp} ; Keijiro Kiyoshima ; Akira Yokomizo ; Ario Takeuchi ; Eiji Kashiwagi ; Takashi Dejima ; Ryosuke Takahashi ; Junichi Inokuchi ; Katsunori Tatsugami ; Masatoshi Eto
• 关键词：bladder neoplasms ; neoplasm recurrence ; local ; androgen antagonists ; prevention and control ; 5-alpha reductase inhibitors
• 刊名：The Journal of Urology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：197
• 期：2
• 页码：308-313
• 全文大小：187 K
• 卷排序：197

文摘

We determined whether intravesical recurrence is affected by inhibition of androgen signaling among men with nonmuscle invasive bladder cancer.Materials and MethodsWe examined the intravesical recurrence rate among men treated with or without androgen suppression therapy by androgen deprivation therapy for prostate cancer or 5α-reductase inhibitor dutasteride for benign prostatic hyperplasia.ResultsWe studied 228 men, including 32 with and 196 without androgen suppression therapy. During a median followup of 3.6 and 3.0 years intravesical recurrence developed in 4 (12.5%) and 59 men (30.1%) with and without androgen suppression therapy, respectively. On multivariate analysis multiple tumors (HR 1.82, p = 0.027), a large tumor (HR 2.13, p = 0.043) and ever smoking (HR 2.45, p = 0.020) as well as the presence of androgen suppression therapy (HR 0.36, p = 0.024) were independent risk factors for intravesical recurrence. Notably, tumor progressed to muscle invasive bladder cancer in 6 men (3.1%) without androgen suppression therapy. No man with androgen suppression therapy progressed to muscle invasive bladder cancer.ConclusionsOur study suggests the possibility of androgen suppression therapy as prophylaxis for intravesical recurrence of bladder cancer. Further explorations are warranted of the prophylactic effect of androgen suppression therapy on bladder cancer pathogenesis.