TY - JOUR

T1 - Risk of Depression After Radical Prostatectomy

T2 - A Nationwide Registry-based Study

AU - Friberg, Anne Sofie

AU - Dalton, Susanne Oksbjerg

AU - Larsen, Signe Benzon

AU - Andersen, Elisabeth W.

AU - Krøyer, Anja

AU - Helgstrand, John Thomas

AU - Røder, Martin Andreas

AU - Johansen, Christoffer

AU - Brasso, Klaus

PY - 2021

Y1 - 2021

N2 - BackgroundDevelopment of depression in prostate cancer patients depends on multiple disease- and patient-related factors.ObjectiveTo investigate the risk of depression following radical prostatectomy focussing on the impact of surgery and subsequent treatment with salvage radiation or androgen deprivation therapy.Design, setting, and participantsA population-based cohort study of 5570 men who underwent radical prostatectomy in Denmark from 1998 to 2011 was identified in the Danish Prostate Cancer Registry.Outcome measurements and statistical analysisData on covariates and primary outcome defined as a hospital contact for depression or a redeemed antidepressant prescription were obtained from nationwide Danish registries. The risk of depression was evaluated using cumulative incidence functions and Cox models with time since surgery as an underlying time scale. Exposure to salvage procedures was included as time-varying covariates, and analyses were adjusted for confounders.Results and limitationsThe cumulative incidence of depression was increased in men who had undergone surgery compared with cancer-free men throughout follow-up of up to 18 yr, particularly among men on androgen deprivation therapy. Compared with no subsequent treatment, the risk of depression was increased with subsequent androgen deprivation therapy (hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.4–2.3), salvage radiation (HR 1.3, 95% CI 1.0–1.6), and the treatments combined (HR 2.2, 95% CI 1.8–2.8) after adjustments for age, year of surgery, income, and cohabitation status. Further adjustment for comorbidity hardly changed the estimates.ConclusionsRadical prostatectomy and subsequent salvage procedures increase the risk of depression, and men with subsequent androgen deprivation therapy are mainly at risk. Clinicians should thus be aware of depressive symptoms in patients receiving treatment for postsurgical relapse.Patient summaryIn a population-based study, we found that radical prostatectomy and subsequent treatments with either radiation or endocrine manipulation significantly increased the risk of developing clinical depression.

AB - BackgroundDevelopment of depression in prostate cancer patients depends on multiple disease- and patient-related factors.ObjectiveTo investigate the risk of depression following radical prostatectomy focussing on the impact of surgery and subsequent treatment with salvage radiation or androgen deprivation therapy.Design, setting, and participantsA population-based cohort study of 5570 men who underwent radical prostatectomy in Denmark from 1998 to 2011 was identified in the Danish Prostate Cancer Registry.Outcome measurements and statistical analysisData on covariates and primary outcome defined as a hospital contact for depression or a redeemed antidepressant prescription were obtained from nationwide Danish registries. The risk of depression was evaluated using cumulative incidence functions and Cox models with time since surgery as an underlying time scale. Exposure to salvage procedures was included as time-varying covariates, and analyses were adjusted for confounders.Results and limitationsThe cumulative incidence of depression was increased in men who had undergone surgery compared with cancer-free men throughout follow-up of up to 18 yr, particularly among men on androgen deprivation therapy. Compared with no subsequent treatment, the risk of depression was increased with subsequent androgen deprivation therapy (hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.4–2.3), salvage radiation (HR 1.3, 95% CI 1.0–1.6), and the treatments combined (HR 2.2, 95% CI 1.8–2.8) after adjustments for age, year of surgery, income, and cohabitation status. Further adjustment for comorbidity hardly changed the estimates.ConclusionsRadical prostatectomy and subsequent salvage procedures increase the risk of depression, and men with subsequent androgen deprivation therapy are mainly at risk. Clinicians should thus be aware of depressive symptoms in patients receiving treatment for postsurgical relapse.Patient summaryIn a population-based study, we found that radical prostatectomy and subsequent treatments with either radiation or endocrine manipulation significantly increased the risk of developing clinical depression.

KW - Antidepressant drugs

KW - Depression

KW - Prostate cancer

KW - Survivorship

U2 - 10.1016/j.euo.2019.06.020

DO - 10.1016/j.euo.2019.06.020

M3 - Journal article

C2 - 31345731

AN - SCOPUS:85069612238

VL - 4

SP - 601

EP - 608

JO - European urology oncology

JF - European urology oncology

SN - 2588-9311

IS - 4

ER -