OBJECTIVES:

Prostate cancer is one of the most common cancers in Korea, and it is necessary to generate evidence that can be used in clinical practice through comparison of short and long term effects between surgical therapy and hormonal therapy. The purpose of this study was to produce clinical evidence of the risk of cardiovascular disease in surgical therapy and hormonal therapy among patients with prostate cancer.

METHODS:

We linked three databases from 2002 to 2015; the Korea Central Cancer Registry, National Health Insurance Service claims data, and the cause of death data from Statistics Korea. Data were stratified into the stage of cancer, localized and regional, based on a subject age of 75 years, and propensity score matching was conducted based on the general clinical features of patients. The cumulative incidence risk ratio of cardiovascular disease within 5 year was calculated by using the Cox proportional hazards model.

RESULTS:

The cumulative incidence risk ratio of cardiovascular disease was 0.3665 in surgical therapy and 0.4949 in hormonal therapy. Compared to surgical therapy group, the hazard ratio of cardiovascular disease was 62% (HR=1.62, 95% CI 1.40-1.86; p<0.001) higher in hormonal therapy group. In patients who had localized prostate cancer with aged 75 or more, the hazard ratio of cardiovascular disease in hormonal therapy was 78% (HR=1.78, 95% CI 1.19-2.66; p=0.0048) higher than surgical therapy. Also, in comparison with surgical therapy, the hazard ratio of cardiovascular disease in patients who had localized prostate cancer with aged under 75 was 1.71 (HR=1.71, 95% CI 1.40-2.08; p<0.0001) in hormonal therapy.

CONCLUSIONS:

This study shows that the cumulative incidence risk ratio of cardiovascular disease within 5 year for hormonal therapy group was higher than surgical therapy group in South Korea. Our results could be used in determining the treatment direction of patients with prostate cancer.