ESTRO 2024 - Abstract Book

S2324

Clinical - Urology

ESTRO 2024

Material/Methods:

Between October 2000 and September 2010, 1230, prostate cancer pts were randomized into 2 phase III trials: 600 with intermediate-risk prostate cancer (IRPC) treated with prostate radiotherapy (PRT) alone (200 pts) or PRT + 6 months (m) of androgen deprivation therapy (ADT) (400 pts) and 630 high-risk prostate cancer (HRPC) treated with pelvic + PRT and ADT≥ 18 months. 153 IRPC pts and 197 HRPC presented biochemical failure and received salvage ADT. Cardiovascular (CV) history was collected at baseline for both studies. Causes of death were compiled up to September 2023. Cardiovascular death (CVD) was classified into 2 groups: events of cardiac origin (ECO) and of extra-cardiac vascular origin (EECO). We obtained data of CVD from 2000 to 2021 in the general male population aged 50 and over from the Canadian population data provided by Statistics Canada (Statistics Canada. Table 13-10-0392-01 Deaths and age-specific mortality rates, by selected grouped causes, DOI: https://doi.org/10.25318/1310039201-eng). We compared the rate of CVD between the two cohorts with the chi-square test. Information on cause of death was not available in 165/1230 (13.4%) pts. Reasons for that include no further follow- after 10 years (126 pts), lost to follow-up (21 pts) and withdrawal from the study (18 pts). Because the median follow-up time for these patients was 11 years (interquartile range: 10.2-11.9), it was decided to include them in the analysis and consider them alive until last follow-up. Results are reported with a median follow-up of 15.3 years (interquartile range: 12.1 to 18.5). 722/1230 (58.7%) prostate cancer pts had died. Considering the follow-up of all 1230 pts, the incidence of death from all causes was 5.23 deaths/100 person-years. Among the 722 deaths, 149 (20.6%) were due to cardiovascular disease, representing the 2nd cause of death in this localised prostate cancer group. Notably, 43.3% occurred after 10 years of follow up. The 149 CVD are divided into 111 ECO (74.5%) and 38 EECO (25.5%). Median age at randomization was 72 years and it was 82 years at time of CVD. According to Statistics Canada, in the male Canadian population aged 50 and over, the average annual rate of CVD among death from all causes is 28.9% (range: 25.4% to 33.4%). The CVD rate in this cohort of prostate cancer pts was significantly lower than the Canadian average rate (20.6% vs. 28.9%, p<0.001). Results:

Conclusion:

In our cohort of localized prostate cancer, one quarter of deaths were due to events of cardiac origin. Similar to the general population, CVD was the second cause of all deaths. Despite the use of ADT, the CVD rate was significantly lower than the one reported for the general Canadian population.

Keywords: Cardiovascular death, prostate cancer/population