liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer: Evaluation of cardiovascular events in a randomized trial
Karolinska University Hospital Solna.
Umeå University Hospital.
Sahlgrens University Hospital.
Karolinska University Hospital Huddinge.
Show others and affiliations
2011 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 45, no 5, 346-353 p.Article in journal (Refereed) Published
Abstract [en]

Objective. This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin (R)) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular disease. Material and methods. Nine-hundred and fifteen patients with T0-4, Nx, M1, G1-3, hormone- naive prostate cancer were randomized to treatment with PEP 240 mg i.m. twice a month for 2 months and thereafter monthly, or to flutamide (Eulexin (R)) 250 mg per os three times daily in combination with either triptorelin (Decapeptyl (R)) 3.75 mg i.m. per month or on an optional basis with bilateral orchidectomy. Pretreatment cardiovascular morbidity was recorded and cardiovascular events during treatment were assessed by an experienced cardiologist. A multivariate analysis was done using logistic regression. Results. There was a significant increase in cardiovascular events during treatment with PEP in patients with previous ischaemic heart disease (p = 0.008), ischaemic cerebral disease (p = 0.002), intermittent claudication (p = 0.031) and especially when the whole group of patients with pretreatment cardiovascular diseases was analysed together (p andlt; 0.001). In this group 33% of the patients had a cardiovascular event during PEP treatment. In the multivariate analysis PEP stood out as the most important risk factor for cardiac complications (p = 0.029). Even in the CAD group there was a significant increase in cardiovascular events in the group with all previous cardiovascular diseases taken together (p = 0.036). Conclusions. Patients with previous cardiovascular disease are at considerable risk of cardiovascular events during treatment with high-dose PEP and even during CAD therapy. Patients without pretreatment cardiovascular morbidity have a moderate cardiovascular risk during PEP treatment and could be considered for this treatment if the advantages of this therapy, e. g. avoidance of osteopenia and hot flushes and the low price, are given priority.

Place, publisher, year, edition, pages
Informa Healthcare , 2011. Vol. 45, no 5, 346-353 p.
Keyword [en]
cardiovascular events, cardiovascular risk factors, combined androgen deprivation, parenteral oestrogen therapy, prostate cancer, randomized multicentre trial, skeletal metastases
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-71771DOI: 10.3109/00365599.2011.585820ISI: 000295890500008OAI: diva2:453963
Funding Agencies|Ferring AB, Malmo, Sweden||Ferring Laegemidler A/S Copenhagen, Denmark||Pharmacia AB, Uppsala, Sweden||Schering-Plough AB, Stockholm, Sweden||Available from: 2011-11-04 Created: 2011-11-04 Last updated: 2011-11-04

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Varenhorst, Eberhard
By organisation
UrologyFaculty of Health SciencesDepartment of Urology in Östergötland
In the same journal
Scandinavian Journal of Urology and Nephrology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 52 hits
ReferencesLink to record
Permanent link

Direct link