Current attitudes of Canadian urologists towards surgical castration in the treatment of prostate cancer

Anderson, Patrick T.; Rowe, Neal

doi:10.5489/cuaj.6834

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Indeed, we showed that the preference for specific modalities of ADT changed over time. This change maybe partly related to the change in local medical reimbursement system, as well as an overwhelming preference for medical castration over BO in more recent years which was consistent with survey studies showing an estimated two-third of clinicians not considering or offering BO to eligible patients with PCa [ 20 , 21 ]. It was possible that similar changes in the selection of patients for ADT have influenced the cardiovascular outcomes.…”

Section: Discussionsupporting

confidence: 69%

Temporal trends in cardiovascular burden among patients with prostate cancer receiving androgen deprivation therapy: a population-based cohort study

Chan¹,

Satti²,

Lee

et al. 2023

Br J Cancer

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Background Although androgen deprivation therapy (ADT) is associated with cardiovascular risks, the extent and temporal trends of cardiovascular burden amongst patients with prostate cancer receiving ADT are unclear. Methods This retrospective cohort study analyzed adults with PCa receiving ADT between 1993–2021 in Hong Kong, with follow-up until 31/9/2021 for the primary outcome of major adverse cardiovascular events (MACE; composite of cardiovascular mortality, myocardial infarction, stroke, and heart failure), and the secondary outcome of mortality. Patients were stratified into four groups by the year of ADT initiation for comparisons. Results Altogether, 13,537 patients were included (mean age 75.5 ± 8.5 years old; mean follow-up 4.7 ± 4.3 years). More recent recipients of ADT had more cardiovascular risk factors and used more cardiovascular or antidiabetic medications. More recent recipients of ADT had higher risk of MACE (most recent (2015–2021) vs least recent (1993–2000) group: hazard ratio 1.33 [1.11, 1.59], P = 0.002; Ptrend < 0.001), but lower risk of mortality (hazard ratio 0.76 [0.70, 0.83], P < 0.001; Ptrend < 0.001). The 5-year risk of MACE and mortality for the most recent group were 22.5% [20.9%, 24.2%] and 52.9% [51.3%, 54.6%], respectively. Conclusions Cardiovascular risk factors were increasingly prevalent amongst patients with prostate cancer receiving ADT, with increasing risk of MACE despite decreasing mortality.

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Section: Discussionsupporting

confidence: 69%