title: [Treatment of prostate cancer according to life expectancy, comorbidity and clinical practice guidelines].
abstract: BACKGROUND
  To describe the treatment of prostate cancer patients according to life expectancy, risk and comorbidity, to examine the degree to which Clinical Practice Guidelines (CPG) are followed, and to register secondary effects after one year.
  
  
  METHODS
  Retrospective study of patients diagnosed with prostate cancer in a hospital in 2011. Socio-demographic variables, as well as comorbidity (Charlson index), tumor characteristics, treatments and secondary effects were collected. A bivariate analysis was performed using the Chi square test.
  
  
  RESULTS
  One hundred and fourteen patients were identified. Life expectancy was higher than 10 years in 92.1%; 50% had low comorbidity, 36% medium and 14% high. Surgery was performed in 56.2%, more often in patients with intermediate-risk and low comorbidity; radiotherapy in 13.2%, more often in patients with high-risk and low comorbidity; hormonal therapy in 21.9%, more often in patients with medium comorbidity, and deferred treatment in 12.3%. CPG recommendations were not followed in 38.6%, especially in high-risk patients, 58.1%. Regarding adverse effects, 70% of patients treated with surgery presented urinary incontinence, and 48.3% erectile dysfunction. On the other hand, 17.15% of patients treated with hormonal therapy presented a cardiovascular disease, and 32.5% worsening of a cardiovascular risk factor.
  
  
  CONCLUSIONS
  Treatment of prostate cancer takes into account risk and comorbidity, but there could be improvement in following CPG guidelines, especially in elderly patients. It is advisable to develop preventive strategies to avoid cardiovascular effects in patients with hormonal therapy.
authors.affiliation: Registro de cáncer de Mallorca, Dirección General de Salud Pública y Consumo, Palma de Mallorca, 07003, Spain. abarcelo@dgsanita.caib.es.
authors.forename: A
authors.initials: A
authors.lastname: Barceló Obrador
authors.forename: M
authors.initials: M
authors.lastname: Ramos
authors.forename: Mt
authors.initials: M
authors.lastname: de la Iglesia
authors.forename: M
authors.initials: M
authors.lastname: Zaforteza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies