Endocrine Disrupting-Chemicals and Biochemical Recurrence of Prostate Cancer after Prostatectomy: A cohort study in Guadeloupe (French West Indies)
Menée en Guadeloupe à partir de données portant sur 326 patients atteints d'un cancer localisé de la prostate traité par prostatectomie radicale, cette étude de cohorte évalue l'effet, sur le risque de récidive biochimique (durée médiane de suivi : 6,1 ans après le traitement chirurgical), d'une exposition au chlordécone, au DDE (dichlorodiphényldichloroéthylène) ou au PCB-135 (biphényle polychloré non apparenté à la dioxine)
Previous studies have suggested that exposure to environmental chemicals with hormonal properties, also called endocrine disrupting chemicals, may be involved in the occurrence of prostate cancer. Such exposure may also influence the treatment outcome as it is still present at the time of diagnosis, the beginning of therapy, and beyond. We followed 326 men in Guadeloupe (French West Indies) who underwent radical prostatectomy as primary treatment of localized prostate cancer. We analyzed the relationship between exposure to the estrogenic chlordecone, the anti-androgenic dichlorodiphenyldichloroethylene (DDE, the main metabolite of the insecticide DDT), and the non-dioxin-like polychlorinated biphenyl congener 153 (PCB-153) with mixed estrogenic/anti-estrogenic properties and the risk of biochemical recurrence after surgery. After a median follow-up of 6.1 years after surgery, we found a significant increase in the risk of biochemical recurrence, with increasing plasma chlordecone concentration (adjusted hazard ratio = 2.51; 95% Confidence Interval: 1.39-4.56 for the highest versus lowest quartile of exposure; p trend = 0.002). We found no associations for DDE or PCB-135. These results shown that exposure to environmental estrogens may negatively influence the outcome of prostate cancer treatment. This article is protected by copyright. All rights reserved.