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LHRH analog therapy is associated with worse metabolic side effects than bilateral orchiectomy in prostate cancer

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A Letter to the Editor to this article was published on 25 February 2017

Abstract

Purpose

The morbidity associated with metabolic syndrome induced by androgen deprivation therapy (ADT) in prostate cancer (PCa) has not been widely studied. There are no studies comparing surgical and pharmacological castration with regards to their metabolic side effects. The aim of this study was to compare both modalities.

Methods

A prospective observational study was conducted in men with PCa and with indications of any ADT. The participants were divided into two groups: (1) bilateral orchiectomy and (2) LHRH analogs. The metabolic profile was assessed before and during the period of ADT. Bioelectrical impedance analysis (BIA) and bone mineral density were measured before and after 6 months of treatment. The data were analyzed using the Chi-squared test, Student’s t test, Bonferroni’s test, and ANOVA.

Results

We enrolled 102 men for analysis, of whom 46 (54.9 %) had been subjected to bilateral orchiectomy and 56 (54.9 %) had been subjected to treatment with LHRH analogs. The basal metabolic profile, body mass index, and BIA were similar between the two groups. The oncologic control (PSA and testosterone) was also similar in both groups. In the intergroup comparison, insulin resistance (p = 0.044) and hemoglobin (p = 0.001) were worse in the group that used LHRH analogs, which was mainly diabetic patients (p = 0.007).

Conclusion

This study showed that LHRH analogs had worse effects relative to insulin resistance, mainly in diabetic patients, and induced more anemia and bone demineralization compared to surgical castration. Further prospective, randomized, and comparative studies are needed for metabolic syndrome in ADT modalities.

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Authors and Affiliations

  1. Department of Urology, Barretos Cancer Hospital, Antenor Duarte Vilela St, 1331, Bairro Dr Paulo Prata, Barretos, CEP: 14.784.400, Brazil

    Andreza Vargas, Roberto Dias Machado, Daniel Ianni Filho, Carlos Eduardo Paiva & Eliney Ferreira Faria

  2. Department of Urology, University of São Paulo, Av. Bandeirantes, 3.900 Monte Alegre, Ribeirão Prêto, SP, CEP: 14040-900, Brazil

    Rodolfo Borges dos Reis

  3. Department of Urology, ABC Medical School, Av. Príncipe de Gales, 821 - Príncipe de Gales, Santo André, SP, CEP: 09060-650, Brazil

    Marcos Tobias-Machado

  4. Alameda Nicarágua 252, Barretos, São Paulo, Brazil

    Eliney Ferreira Faria

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  1. Andreza Vargas
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  2. Roberto Dias Machado
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  3. Daniel Ianni Filho
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  4. Carlos Eduardo Paiva
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  5. Rodolfo Borges dos Reis
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  6. Marcos Tobias-Machado
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Corresponding author

Correspondence to Eliney Ferreira Faria.

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Conflict of interest

We declare there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical standards

This project was approved by ethics committee in research and is registered in national ethics database. Number: CAAE:05888012.6.0000.5437.

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Vargas, A., Machado, R.D., Filho, D.I. et al. LHRH analog therapy is associated with worse metabolic side effects than bilateral orchiectomy in prostate cancer. World J Urol 34, 1621–1628 (2016). https://doi.org/10.1007/s00345-016-1831-5

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  • DOI: https://doi.org/10.1007/s00345-016-1831-5

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