Cancer - Prostate(구연) (E-141)

한국인 전립선암 생존자들의 골다공증성 골절 위험도 분석: 건강보험공단 데이터베이스 기반 전국민 코호트 연구
¹을지대학병원 비뇨의학과
²서울대학교병원 강남센터 가정의학과
³숭실대학교 통계학과
⁴가톨릭대학교 의과대학 의학통계학과
5삼성서울병원 가정의학과
신현빈¹, 박현식¹, 김영중¹, 이희태¹, 유정은², 한경도³, 박상현³, 신동욱*⁴, 박진성*¹
<strong>Background:</strong> We analyzed the risk of fracture in prostate cancer (PC) survivors compared to that in the general population and according to the primary treatment.
<strong>Methods:</strong> This retrospective longitudinal cohort study used the Korean National Health Insurance Service Database. From 2007 to 2013, a total of 41,733 PC survivors newly diagnosed with PC were identified and matched to non-cancer controls. For selection of the control group, 1:3 matching was performed serially year by year such that PC patients who were diagnosed in a specific year were matched to control subjects who were alive during the same year based on age and sex. Cox proportional hazards regression analysis was performed to determine the relative risk of fracture.
<strong>Results:</strong> Compared to the matched controls, PC survivors had a higher risk of fracture (aHR, 1.39; 95% CI, 1.33–1.45). Compared to the matched controls, the active surveillance/watchful waiting and radiotherapy group showed a similar risk of fracture (aHR, 1.08; 95% CI, 0.98–1.20 and aHR, 1.04; 95% CI, 0.63–1.73, respectively). PC survivors who underwent surgery showed a lower risk of fracture (aHR, 0.89; 95% CI, 0.82–0.96), while those who underwent surgery + androgen deprivation therapy (ADT) (aHR, 1.41; 95% CI, 1.26–1.57), radiotherapy + ADT (aHR, 1.86; 95% CI, 1.50–2.32), and only ADT (aHR, 1.92; 95% CI, 1.82–2.02) showed a higher risk of fracture than the control group <strong>(Table 1).
Conclusion:</strong> The risk of fracture differed according to the primary treatment method for PC; survivors who underwent AS/WW or RT had a similar risk, and survivors who underwent surgery had a lower risk of fracture compared to that of the general population. However, PC survivors treated with ADT showed a higher risk of fracture than the other PC treatment groups or the general population. Therefore, more attention and preventive bone care are required for PC survivors who receive ADT.
keywords : Prostate cancer, fracture, androgen deprivation therapy

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