Chemotherapy and Heart-Specific Mortality in Elderly Men with Prostate Cancer: A Propensity Score Matching Analysis

Area of Science:

• Oncology
• Cardiology
• Geriatrics

Background:

• Prostate cancer (PC) is a common malignancy in men.
• Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of non-cancer death in PC patients.
• Investigating chemotherapy's impact on heart-specific mortality (HSM) in elderly PC patients is crucial.

Purpose of the Study:

• To determine if chemotherapy increases heart-specific mortality (HSM) in elderly patients with prostate cancer (PC).

Main Methods:

• Utilized data from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2018).
• Employed multivariate logistic regression and 1:1 propensity score matching to analyze factors influencing chemotherapy use and its impact on HSM and other cause mortality (OCM).
• A competing risk model and cumulative incidence plot were used for analysis.

Main Results:

• 135,183 elderly PC patients were analyzed; 1,361 received chemotherapy.
• Chemotherapy use was associated with older age, marital status, higher TNM stage, and higher tumor histological grade.
• After propensity score matching, patients without chemotherapy had significantly higher HSM (HR 2.54; P=0.002) compared to those who received chemotherapy.

Conclusions:

• Chemotherapy does not increase heart-specific mortality in elderly prostate cancer patients.
• Chemotherapy may benefit long-term survival despite potential cardiotoxicity.
• HSM was found to be significantly higher in elderly PC patients who did not receive chemotherapy.