A multi-center analysis involving nearly 1,500 veterans has suggested that those exposed to Agent Orange were at higher risk for recurrence after radical prostatectomy.
Shah and colleagues at three VA hospitals and six associated medical schools investigated the clinicopathological characteristics and outcomes after radical prostatectomy (RP) among 1,495 patients with prostate cancer and previous exposure to Agent Orange (AO), particularly with regard to any relationship to race.
The results of their analysis showed the following results:
- 206/1,495 (14 percent) of the patients had been exposed to AO.
- The men with AO exposure were significantly more likely to be black, younger, treated more recently, have a higher body mass index, have clinical stage T1 disease, and have lower preoperative PSA levels.
- Exposure to AO was not significantly related to adverse pathological features but was significantly associated with risk for biochemical progression risk and with shorter PSA doubling times after recurrence (8.2 vs 18.6 months).
- When stratified by race, these associations were present and similar in both races, with no significant interaction between race and AO exposure for predicting biochemical recurrence or mean adjusted PSA doubling time.
The authors conlude that patients exposed to AO and treated with RP were more likely to be black, to present with lower risk features, to have an increased risk of biochemical progression, and to have a shorter PSA doubling time after recurrence. They go on to state that, “These findings suggest that among selected men who choose RP, AO exposure might be associated with more aggressive prostate cancer.”
Additional information about this trial, and comments from an interview with Martha Terris, MD, the senior author, were published today in Science Daily.
Filed under: Living with Prostate Cancer, Management, Risk, Treatment | Tagged: Agent Orange, progression, radical prostatectomy, risk
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