TY - JOUR
T1 - Impact of 23-valent pneumococcal polysaccharide vaccination on the frequency of pneumonia-related hospitalization and survival in elderly patients with prostate cancer
T2 - A seven-year nationwide matched cohort study
AU - Li, Chung Yi
AU - Chen, Liang Cheng
AU - Lin, Hon Yi
AU - Lee, Moon Sing
AU - Hung, Shih Kai
AU - Lai, Chun Liang
AU - Huang, Li Wen
AU - Yu, Ben Hui
AU - Hsu, Feng Chun
AU - Chiou, Wen Yen
N1 - Funding Information:
We are grateful to the Health and Welfare Data Science Center at National Cheng Kung University Hospital for providing administrative and technical support, and Dalin Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation for funding support.
Funding Information:
This study was supported by research grants from the Dalin Tzu Chi Hospital (grant DTCRD107‐I‐07) and the Buddhist Tzu Chi Medical Foundation (grant TCMF‐A 108‐01‐06).
Publisher Copyright:
© 2020 American Cancer Society
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is indicated for adults who have a high risk of pneumonia; however, its effectiveness in patients with prostate cancer who are at a risk of pneumonia because of age and cancer treatments, including androgen-deprivation therapy, is unknown. Methods: Between 2000 and 2010, 38,735 patients with prostate cancer were diagnosed in Taiwan. After exclusions and exact matching for age, previous pneumonia, and influenza vaccination, 2188 vaccinated patients and 2188 unvaccinated patients were recruited. The incidence density of all-cause bacterial pneumonia hospitalizations was analyzed. Results: Over 7 years of follow-up, patients who received the PPSV23 had a significantly lower incidence density, with 142.8 per 1000 person-years versus 162.0 per 1000 person-years for unvaccinated patients. More patients in the vaccinated cohort were never hospitalized for pneumonia compared with those in the unvaccinated cohort (64.2% vs 62.2%, respectively). After adjusting for the Charlson comorbidity index, cancer treatment modalities, and socioeconomic levels, the risk of pneumonia-related hospitalization in the PPSV23 vaccination cohort was 0.48 times lower than that in the unvaccinated cohort (adjusted incidence rate ratio, 0.48; P =.046). For patients who received the influenza vaccination, subgroup analysis demonstrated that PPSV23 vaccination significantly decreased the risk (adjusted incidence rate ratio, 0.45; P <.001). Compared with unvaccinated controls, PPSV23-vaccinated patients had a lower cumulative incidence for the first occurrence of pneumonia-related hospitalization (34.49% vs 36.36%; P =.178) and higher overall survival (47.5% and 42.3%, respectively; P <.001). Conclusions: Vaccination of elderly patients who have prostate cancer with the relatively common and inexpensive PPSV23 can decrease the risk of pneumonia and prolong survival.
AB - Background: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is indicated for adults who have a high risk of pneumonia; however, its effectiveness in patients with prostate cancer who are at a risk of pneumonia because of age and cancer treatments, including androgen-deprivation therapy, is unknown. Methods: Between 2000 and 2010, 38,735 patients with prostate cancer were diagnosed in Taiwan. After exclusions and exact matching for age, previous pneumonia, and influenza vaccination, 2188 vaccinated patients and 2188 unvaccinated patients were recruited. The incidence density of all-cause bacterial pneumonia hospitalizations was analyzed. Results: Over 7 years of follow-up, patients who received the PPSV23 had a significantly lower incidence density, with 142.8 per 1000 person-years versus 162.0 per 1000 person-years for unvaccinated patients. More patients in the vaccinated cohort were never hospitalized for pneumonia compared with those in the unvaccinated cohort (64.2% vs 62.2%, respectively). After adjusting for the Charlson comorbidity index, cancer treatment modalities, and socioeconomic levels, the risk of pneumonia-related hospitalization in the PPSV23 vaccination cohort was 0.48 times lower than that in the unvaccinated cohort (adjusted incidence rate ratio, 0.48; P =.046). For patients who received the influenza vaccination, subgroup analysis demonstrated that PPSV23 vaccination significantly decreased the risk (adjusted incidence rate ratio, 0.45; P <.001). Compared with unvaccinated controls, PPSV23-vaccinated patients had a lower cumulative incidence for the first occurrence of pneumonia-related hospitalization (34.49% vs 36.36%; P =.178) and higher overall survival (47.5% and 42.3%, respectively; P <.001). Conclusions: Vaccination of elderly patients who have prostate cancer with the relatively common and inexpensive PPSV23 can decrease the risk of pneumonia and prolong survival.
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U2 - 10.1002/cncr.33203
DO - 10.1002/cncr.33203
M3 - Article
C2 - 32997342
AN - SCOPUS:85091729202
SN - 0008-543X
VL - 127
SP - 124
EP - 136
JO - Cancer
JF - Cancer
IS - 1
ER -