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Phosphodiesterase Type 5 Inhibitor Use and Disease Recurrence After Prostate Cancer Treatment
NYU, Dept Urol Populat Hlth, 550 1st Ave, New York, NY 10016 USA.;NYU, Laura & Isaac Perlmutter Canc Ctr, 550 1st Ave, New York, NY 10016 USA..
Univ Uppsala Hosp, Registers & Care Programs, Uppsala, Sweden..
Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden..
Univ Med Ctr Hamburg Eppendorf, Martini Clin Prostate Canc Ctr, Hamburg, Germany..
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2016 (English)In: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 70, no 5, p. 824-828Article in journal (Refereed) Published
Abstract [en]

Background: Phosphodiesterase type 5 inhibitor (PDE5i) use is common for management of erectile dysfunction. Single-institution studies have reported conflicting data on the relationship between PDE5i use and biochemical recurrence of prostate cancer (BCR) after radical prostatectomy. Objective: To evaluate the association between PDE5i use and BCR after radical prostatectomy and radiation therapy in a nationwide population-based cohort. Design, setting, and participants: This was a nested case-control study using the National Prostate Cancer Register of Sweden linked to the Prescribed Drug Register. Among men with localized prostate cancer who underwent primary radical prostatectomy or radiation therapy during 2006-2007 with 5 yr of follow-up, 293 had BCR after treatment (cases). For each case we identified 20 BCR-free controls (n = 5767) using incidence density sampling. Outcome measurements and statistical analysis: Multivariable conditional logistic regression was used to examine the association between PDE5i use and BCR risk. Separate multivariable models including clinical variables for men undergoing prostatectomy or radiotherapy and including surgical pathology after prostatectomy were also analyzed. Results and limitations: PDE5i use was not associated with BCR after radical prostatectomy (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.59-1.03) or radiation therapy (OR 0.98, 95% CI 0.49-1.97) after adjusting for marital status, education, income, prostate-specific antigen, clinical stage, Gleason score, and proportion of positive biopsies. Results were similar after additional adjustment for surgical pathology (OR 0.86, 95% CI 0.64-1.16). Men whose cumulative number of PDE5i pills was above the median had a slightly lower BCR risk after prostatectomy in the clinical model, and no difference in BCR risk after adjustment for pathologic tumor features. Conclusions: Our results from a population-based cohort suggest that BCR risk is not higher among men using PDE5i after prostate cancer treatment. Patient summary: Erectile dysfunction medications are not associated with a higher risk of disease recurrence after prostate cancer treatment.

Place, publisher, year, edition, pages
2016. Vol. 70, no 5, p. 824-828
Keywords [en]
Phosphodiesterase inhibitors, Viagra, Erectile dysfunction, Prostate cancer, Recurrence
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:uu:diva-307516DOI: 10.1016/j.eururo.2015.12.013ISI: 000385515600029PubMedID: 26743040OAI: oai:DiVA.org:uu-307516DiVA, id: diva2:1048203
Funder
Swedish Research Council, 825-2012-5047Swedish Cancer Society, 11 0471Available from: 2016-11-21 Created: 2016-11-17 Last updated: 2018-04-26Bibliographically approved

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