5α-reductase Inhibitors Impact Prognosis of Urothelial Carcinoma

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2020 Sep 12

PMID 32917158

Citations 13

Authors

Chien-Sheng Wang

Ching-Chia Li

Yung-Shun Juan

Wen-Jeng Wu

Hsiang-Ying Lee

Affiliations

Soon will be listed here.

Abstract

Background: 5α-reductase inhibitors (5-ARIs) inhibit the pathway of converting the testosterone to dihydrotestosterone and are widely used in benign prostatic hyperplasia patients. Since androgen receptor activation may play a role in urothelial tumorigenesis, we conducted this retrospective cohort study to determine whether 5α-reductase inhibitors (5-ARIs) administration is associated with bladder cancer mortality, bladder cancer recurrence and upper tract urothelial carcinoma mortality, using the Taiwan National Health Insurance database.

Methods: The data of this retrospective cohort study were sourced from the Longitudinal Health Insurance Database of Taiwan, compiled by the Taiwan National Health Insurance database from 1996 to 2010. It consists of 18,530 men with bladder cancer, of whom 474 were 5-ARIs recipients and 4384 men with upper tract urothelial carcinoma, of whom 109 were 5-ARIs recipients. Propensity Score Matching on the age and geographic data was done at the ratio of 1:10. We analyzed the odds ratios (OR) and 95% confidence interval (CI) of the risk of bladder cancer death, bladder cancer recurrence rate and upper tract urothelial carcinoma related death by the 5-ARIs administration.

Results: Those who received 5-ARIs showed a lower risk of bladder cancer related death compared to nonusers in multivariable adjusted analysis (OR 0.835, 95% CI 0.71-0.98). However, there was no significant difference in the bladder cancer recurrence rate (OR 0.956, 95% CI 0.82-1.11) and upper tract urothelial carcinoma related mortality in multivariable adjusted analysis (OR 0.814, 95% CI 0.6-1.1).

Conclusions: Patients who receive 5-ARIs have lower bladder cancer related mortality compared to those who don't. 5-ARIs may prove to be a viable strategy to improve bladder cancer outcomes.

Citing Articles

Impact of finasteride on modulating the risk and clinical outcomes of bladder cancer: insights from a comprehensive meta-analysis.

Yu A, Bai Z, Wang Y, Luo Z, Du X, Chen M Front Pharmacol. 2025; 16:1471442.

PMID: 39944628 PMC: 11813867. DOI: 10.3389/fphar.2025.1471442.

A new nomogram for predicting extraurothelial recurrence in patients with upper urinary tract urothelial carcinoma following radical nephroureterectomy.

Wu H, Jia D, Dai X, Cao H, Wang F, Yang T Front Oncol. 2024; 14:1442168.

PMID: 39568567 PMC: 11576284. DOI: 10.3389/fonc.2024.1442168.

Roles of Androgen Receptor Signaling in Urothelial Carcinoma.

Sundi D, Collier K, Yang Y, Diaz D, Pohar K, Singer E Cancers (Basel). 2024; 16(4).

PMID: 38398136 PMC: 10886823. DOI: 10.3390/cancers16040746.

Beyond Prostate Cancer: An Androgen Receptor Splice Variant Expression in Multiple Malignancies, Non-Cancer Pathologies, and Development.

Katleba K, Ghosh P, Mudryj M Biomedicines. 2023; 11(8).

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Stranger Things: New Roles and Opportunities for Androgen Receptor in Oncology Beyond Prostate Cancer.

Leo J, Dondossola E, Basham K, Wilson N, Alhalabi O, Gao J Endocrinology. 2023; 164(6).

PMID: 37154098 PMC: 10413436. DOI: 10.1210/endocr/bqad071.

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