Renal cancer survival and use of 5alpha-reductase inhibitors or androgen deprivation therapy

Abstract

Purpose: Several etiological factors have been implicated in renal cell carcinoma (RCC), and hormonal receptor activity appears to influence RCC-specific mortality. This study aimed to examine the potential association between the use of 5α-reductase inhibitors and androgen deprivation therapy (ADT) and RCC-specific mortality in a population-based cohort of men. Methods: This study included a cohort of 7,720 Finnish men newly diagnosed with RCC between 1995 and 2012. The median follow-up period was 4.75 years. The risk of RCC-specific mortality associated with the use of 5α-reductase inhibitors and androgen deprivation therapy was analyzed using Cox proportional hazards regression. The influence of tumor histology and primary treatment were also evaluated. Long-term risks were assessed in lag-time analyses. Potential confounding by indication was addressed by repeating the analyses for α-blocker users for comparison. Results: Use of 5α-reductase inhibitors prior to RCC diagnosis was associated with a slight risk increase for RCC-specific mortality compared to non-users (HR 1.18, 95% CI 1.02-1.36), with similar association observed also among α-blocker users. However, post-diagnostic use of 5α-reductase inhibitors was not associated with RCC-specific mortality (HR 0.93, 95% CI 0.81-1.07). The lag time analysis did not demonstrate any long-term risk reduction for either 5α-reductase inhibitors or α-blockers. Additionally, no association was observed between ADT use and RCC-specific mortality. Conclusion: Use of 5α-reductase inhibitors or androgen deprivation therapy does not consistently associate with RCC-survival following diagnosis.