Cancer - Prostate(구연) (E-121)

남성호르몬 박탈요법을 받은 전립선암 환자에서 골다공증의 위험인자와 골전이의 연관성
서울대학교병원 비뇨의학과
윤현식, 박대형, 정규환, 유상현, 윤지환, 육형동, 정창욱, 구자현, 김현회, 곽철
Objective
We aimed to find out if risk factors for osteoporosis are related to the risk of bone metastasis in patients with androgen deprivation therapy for prostate cancer.

Patients and methods
We retrospectively analyzed the records of 1,429 patients without bone metastasis on bone scan images who received androgen deprivation therapy for prostate cancer from July 2000 to January 2020 at Seoul National University Hospital. The group of patients with risk factors for osteoporosis (n=792) and the control group of patients without risk factors for osteoporosis (n=637) were compared. The primary endpoint was the occurrence of bone metastasis during the follow-up by bone scan images. Kaplan-Meier analysis with the log-rank test was used to analyze the metastasis-free survival (MFS). Cox proportional-hazards analyses were adjusted for characteristics of the patients and the prostate cancer, past medical history, other cancer treatment received, and the occurrence of bone metastasis.

Results
The mean age of the group with risk factors for osteoporosis and the control group was 70.93 ± 7.84 and 69.19 ± 7.74 years. The median follow-up periods were 41 months in the group with risk factors for osteoporosis and 33 months in the control group. The occurrence of bone metastasis was higher in the group with risk factors for osteoporosis than that of the control group (21.3% vs. 9.6%, p<0.001). The group with risk factors for osteoporosis showed worse 10-year MFS than the controls (71.3% vs. 83.9%, p<0.001). In Cox proportional-hazards analyses, the presence of risk factors for osteoporosis significantly increased the risk of bone metastasis (Hazard ratio [HR] 2.75, 95% CI 1.98-3.82, p<0.001). Moreover, the number of risk factors for osteoporosis and the risk of bone metastasis also showed a significant association. The patients with one or two risk factors and those with three or more risk factors increased the risk of bone metastasis (HR 2.59, 95% CI 1.85-3.62, p<0.001 and 5.39, 95% CI 3.04-9.58, p<0.001).

Conclusions
Risk factors for osteoporosis may be associated with the risk of bone metastasis in patients with androgen deprivation therapy for prostate cancer.
keywords : Prostate cancer, Bone metastasis, Osteoporosis

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