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• W2054246474 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 May 2003Fracture Risk Following Bilateral Orchiectomy L. JOSEPH MELTON, KHALID I. ALOTHMAN, SUNDEEP KHOSLA, SARA J. ACHENBACH, ANN L. OBERG, and HORST ZINCKE L. JOSEPH MELTONL. JOSEPH MELTON Requests for reprints: Division of Epidemiology, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905. More articles by this author , KHALID I. ALOTHMANKHALID I. ALOTHMAN Current address: King Faisal Specialist Hospital, MBC 83, P. O. Box 3354, Riyadh 11211, Saudi Arabia. More articles by this author , SUNDEEP KHOSLASUNDEEP KHOSLA More articles by this author , SARA J. ACHENBACHSARA J. ACHENBACH More articles by this author , ANN L. OBERGANN L. OBERG More articles by this author , and HORST ZINCKEHORST ZINCKE More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000059281.67667.97AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Bone loss has been reported in patients with prostate cancer treated with androgen deprivation therapy. We assess fracture risk following bilateral orchiectomy. Materials and Methods: Through the Rochester Epidemiology Project we identified 429 Olmsted County, Minnesota men who underwent bilateral orchiectomy in 1956 to 2000, almost all for prostate cancer. Fractures were ascertained from comprehensive medical records and compared with expected numbers based on local incidence rates (standardized incidence ratio, SIR). Potential risk factors were assessed with proportional hazards models. Results: During 1961 person-years of followup 161 men experienced 267 fractures, for a cumulative incidence after 15 years of 40% compared to 19% expected (p <0.001). However, 42 were pathological fractures and 82 were found incidentally on radiological surveys for metastasis. Overall fracture risk was increased (SIR 3.42, 95% CI 2.91–3.99) but was reduced by excluding the pathological and incidental fractures (SIR 2.04, 95% CI 1.66–2.47). The increase was largely accounted for by the moderate trauma fractures of the hip, spine and distal forearm traditionally linked with osteoporosis (SIR 3.50, 95% CI 2.71–4.43). In multivariate analyses risk factors for fractures generally included patient age, inactivity, prior radiological diagnosis of osteoporosis, chemotherapy and use of nonsteroidal antiandrogens, while independent risk factors for the traditional osteoporotic fractures included age, inactivity and diagnosis of osteoporosis. Conclusions: Fractures are common in men with prostate cancer due to advanced age, occurrence of pathological fractures and enhanced skeletal surveillance but there remains a significant increase in osteoporotic fracture risk following bilateral orchiectomy. References 1 : Castrated men exhibit bone loss: effect of calcitonin treatment on biochemical indices of bone remodeling. J Clin Endocrinol Metab1989; 69: 523. Google Scholar 2 : Decline in bilateral orchiectomy for prostate cancer in Olmsted County, Minnesota, 1956–2000. Mayo Clin Proc2001; 76: 1199. Google Scholar 3 : Osteoporosis after orchiectomy for prostate cancer. J Urol1997; 157: 439. Link, Google Scholar 4 : Osteoporosis due to androgen deprivation therapy in men with prostate cancer. Urology2001; 58: 101. Google Scholar 5 : Bone loss in men with prostate cancer treated with gonadotropin-releasing hormone agonists. J Clin Endocrinol Metab2001; 86: 2787. 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Crossref, Medline, Google Scholar 13 : Complementary therapies for reducing the risk of osteoporosis in patients receiving luteinizing hormone-releasing hormone treatment/orchiectomy for prostate cancer: a review and assessment of the need for more research. Urology2002; 59: 34. Google Scholar 14 : Bone fractures associated with luteinizing hormone-releasing hormone agonists used in the treatment of prostate carcinoma. Cancer1997; 79: 545. Crossref, Medline, Google Scholar 15 : Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens. Calcif Tissue Int1995; 57: 97. Google Scholar 16 : Progressive osteoporosis during androgen deprivation therapy for prostate cancer. J Urol2000; 163: 181. Link, Google Scholar 17 : Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res1992; 7: 221. Google Scholar 18 : Detailed diagnoses and procedures, National Hospital Discharge Survey, 1992. Series 13: Data from the National Health Survey. Vital Health Stat1994; 13: 1. Google Scholar From the Division of Epidemiology, Department of Health Sciences Research, the Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine and the Department of Urology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMalkowicz S (2009) What Should Urologists Know About Osteoporosis?Journal of Urology, VOL. 182, NO. 6, (2557-2558), Online publication date: 1-Dec-2009.Chang S, Liao J and Shinghal R (2009) Decreasing Use of Luteinizing Hormone-Releasing Hormone Agonists in the United States is Independent of Reimbursement Changes: A Medicare and Veterans Health Administration Claims AnalysisJournal of Urology, VOL. 182, NO. 1, (255-261), Online publication date: 1-Jul-2009.OCKRIM J, LALANI E, BANKS L, SVENSSON W, BLOMLEY M, PATEL S, LANIADO M, CARTER S and ABEL P (2018) TRANSDERMAL ESTRADIOL IMPROVES BONE DENSITY WHEN USED AS SINGLE AGENT THERAPY FOR PROSTATE CANCERJournal of Urology, VOL. 172, NO. 6 Part 1, (2203-2207), Online publication date: 1-Dec-2004.DICKMAN P, ADOLFSSON J, ÅSTRÖM K and STEINECK G (2018) HIP FRACTURES IN MEN WITH PROSTATE CANCER TREATED WITH ORCHIECTOMYJournal of Urology, VOL. 172, NO. 6 Part 1, (2208-2212), Online publication date: 1-Dec-2004.SMITH M (2018) OSTEOPOROSIS AND OBESITY IN MEN RECEIVING HORMONE THERAPY FOR PROSTATE CANCERJournal of Urology, VOL. 172, NO. 5S, (S52-S57), Online publication date: 1-Nov-2004.DIAMOND T, BUCCI J, KERSLEY J, ASLAN P, LYNCH W and BRYANT C (2018) OSTEOPOROSIS AND SPINAL FRACTURES IN MEN WITH PROSTATE CANCER: RISK FACTORS AND EFFECTS OF ANDROGEN DEPRIVATION THERAPYJournal of Urology, VOL. 172, NO. 2, (529-532), Online publication date: 1-Aug-2004. Volume 169Issue 5May 2003Page: 1747-1750 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsosteoporosisepidemiologyprostatic neoplasmsfracturesorchiectomyMetricsAuthor Information L. JOSEPH MELTON Requests for reprints: Division of Epidemiology, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905. More articles by this author KHALID I. ALOTHMAN Current address: King Faisal Specialist Hospital, MBC 83, P. O. Box 3354, Riyadh 11211, Saudi Arabia. More articles by this author SUNDEEP KHOSLA More articles by this author SARA J. ACHENBACH More articles by this author ANN L. OBERG More articles by this author HORST ZINCKE More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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