The Stage at Presentation and Oncologic Outcomes for Agent Orange Exposed and Non-Exposed United States Veterans Diagnosed With Prostate Cancer

Autor: Alexander Tward, Jonathan D. Tward
Rok vydání: 2021
Předmět:
Zdroj: Clinical Genitourinary Cancer. 19:369-369.e7
ISSN: 1558-7673
DOI: 10.1016/j.clgc.2021.01.010
Popis: Introduction It is unknown if Agent Orange (AO)-exposed veterans have worse outcomes than unexposed Veterans after prostate cancer treatment. We evaluated oncologic outcomes based on AO exposure history, accounting for known prognostic covariates not previously studied. Methods US military Veterans diagnosed with prostate adenocarcinoma born between 1930 and 1956 were identified from our prospectively gathered institutional database. Evaluable patients had to have known AO exposure status, age, National Comprehensive Cancer Network risk group, Charlson comorbidity score, smoking status, and type of initial therapy. The risk of death, metastasis, and progression stratified by initial therapy was analyzed using Cox regression. Results Seventy AO-exposed and 561 non-exposed Veterans were identified (median follow-up, 10.0 years). AO-exposed veterans (AOeV) were slightly younger (64.0 vs 65.7 years; P = .013) at diagnosis and presented at more advanced stages (stage 4: 14.3% vs 2.5%) than non-AOeV. There was no difference for overall survival (hazard ratio [HR], 0.86; P = .576; metastasis-free survival (HR, 1.5; P = .212), or progression-free survival (HR, 0.67; P = .060) between AOeV vs non-AOeV in analyses stratified by treatment received accounting for other prognostic covariates. Cigarette smoking was associated with a 2- to 3-fold increased risk of death over those who quit or never smoked. Conclusion Although AOeV do present at a younger age and higher clinical stages than non-AOeV, the oncologic outcomes after accounting for treatments received and other prognostic covariates are similar.
Databáze: OpenAIRE
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