Long-term assessment of adverse cardiovascular events in men receiving intermittent androgen deprivation therapy following radical prostatectomy.

[OBJECTIVES] To assess the relationship of intermittent adverse cardiovascular events (ACE) in men undergoing androgen deprivation therapy (ADT) post radical prostatectomy (RP), since ACE are severe complications associated with ADT following a biochemical recurrence (BCR) post-RP for the treatment of prostate cancer (PC).

[PATIENTS AND METHODS] Retrospective review of prospectively collected data of patients who underwent robot-assisted radical prostatectomy (RARP) with a BCR (n = 407). A total of 308 men with adequate follow-up data included for analysis. A total of 189/308 men in the "treatment group" (TG) were managed with ADT. The comparator group consisted of 119/308 men with no treatment (NT). Regression and Kaplan Meier (KM) analyses were performed to assess predictors of ACE.

[RESULTS] At baseline, patients in the treatment group had higher risk characteristics for PC (preoperative PSA, pathological stage and Gleason grade). Univariate analysis of ACE showed significant predators were age, Charlson comorbidity index (CCI), body mass index (BMI), treatment status and smoking status. In multivariate analysis, treatment status was trending towards significance (p = 0.10) with CCI (p < 0.001) and BMI (p = 0.003) being significant predictors of ACE. In 15-year KM, we observed a significant increase in ACEs (TG 54.4% and NT 41.8%, p = 0.02). Limitations include retrospective design and limited analysis of NT, TG or ADT effects on cardiovascular mortality.

[CONCLUSION] ADT, in our experience, is associated with an increased risk of ACE. We also noted the importance of CCI and BMI as a prognosticating tool for ACE.