title: Prevalence of Cardiovascular Disease and Osteoporosis During Androgen Deprivation Therapy Prescription Discordant to EAU Guidelines: Results From a Multicenter, Cross-sectional Analysis From the CHOsIng Treatment for Prostate canCEr (CHOICE) Study.
abstract: OBJECTIVE
  To analyze the prevalence of cardiovascular disease (CVD) and osteoporosis in patients treated with androgen deprivation therapy (ADT) for prostate cancer (PCa) but not adherent to European Association of Urology (EAU) guidelines.
  
  
  METHODS
  The CHOosIng Treatment for Prostate CanCEr (CHOICE) study was an Italian multicenter, cross-sectional study conducted from December 2010 to January 2012. A total of 1386 patients treated with ADT for PCa (first prescription or renewal of ADT) were selected. According to EAU guidelines, the cohort was categorized in discordant ADT (Group A) and concordant ADT (Group B). The prevalence of CVD and osteoporosis after ADT was recorded.
  
  
  RESULTS
  The final cohort included 1075 patients. According to EAU guidelines adherence, 285 (26.51%) and 790 (73.49%) were considered discordant and concordant, respectively. The proportion of men with Charlson Comorbidity Index  > 2 at baseline was statistically similar in Group A (81.8%) compared to Group B (80.8%) (P = .96). The number of complications reported at enrollment was as follows: cardiovascular in 351 (32.7%), endocrine in 166 (15.4%), sexual in 498 (46.3%), osteoporosis in 181 (16.8%), and gynecomastia in 274 (25.5%) subjects. At the multivariate logistic regression analysis adjusted for confounding factors, discordant ADT was associated with greater risk of cardiovascular complications (odds ratio: 2.07; P < .01) and osteoporosis (odds ratio: 1.75; P = .04).
  
  
  CONCLUSIONS
  About one-third of patients with PCa received inappropriate ADT and showed a greater risk of CVD and osteoporosis. These results could be useful for setting better policy strategies to limit the inappropriateness of ADT prescription.
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.affiliation: Department of Urology, University of Catania, Catania, Italy. Electronic address: giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Sant' Andrea Hospital, Department of Urology, "La Sapienza" University of Roma, Roma, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.affiliation: S.O. Oncologia Radioterapica, Pordenone, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bortolus
authors.affiliation: Urology, Presidio Ospedaliero Gradenigo, Torino, Italy.
authors.forename: Donato
authors.initials: D
authors.lastname: Randone
authors.affiliation: Radiotherapy, IRCC Candiolo, Torino, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Gabriele
authors.affiliation: Radiotherapy, A.O. Santa Maria, Terni, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Trippa
authors.affiliation: Department of Urology, University of Padova, Padova, Italy.
authors.forename: Filiberto
authors.initials: F
authors.lastname: Zattoni
authors.affiliation: Department of Urology, University of Perugia, Perugia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Porena
authors.affiliation: Department of Urology, Università Federico II of Napoli, Napoli, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.affiliation: Department of Urology, University of Firenze, Firenze, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Serni
authors.affiliation: Urologia I, Azienda Ospedaliera San Paolo, Milano, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Del Nero
authors.affiliation: Radiotherapy, ASL of Cagliari, Cagliari, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Lay
authors.affiliation: Radiotherapy, AOU University S. Giovanni Battista Molinette, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.affiliation: Department of Urology, University of Milano, Milano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rocco
authors.affiliation: Urology, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.affiliation: Urology, University of Bari, Bari, Italy.
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Pagliarulo
authors.affiliation: Urology, Ospedale Generale Regionale F. Miulli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ludovico
authors.affiliation: Department of Urology, University Tor Vergata, Roma, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vespasiani
authors.affiliation: Urology, Ospedale Civile Ramazzini, Carpi, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Brausi
authors.affiliation: Department of Urology, University of Brescia, Brescia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Simeone
authors.affiliation: Department of Surgery, Urology Clinic, AOUI Verona, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Novella
authors.affiliation: Department of Urology, University of Genova, Genova, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Carmignani
authors.affiliation: Urology, Centro Uro-Andrologico La CURA, Acireale, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Leonardi
authors.affiliation: Radiotherapy, IRCC Candiolo, Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pinnarò
authors.affiliation: Radiotherapy, AO S. Giovanni Addolorata, Roma, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: De Paula
authors.affiliation: Radiotherapy, Istituto Nazionale per la Ricerca, Genova, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Corvò
authors.affiliation: Department of Urology, University of Chieti, Chieti, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Tenaglia
authors.affiliation: Department of Urology, University of Trieste, Trieste, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siracusano
authors.affiliation: Radiotherapy, Policlinico Universitario Agostino Gemelli, Roma, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mantini
authors.affiliation: Department of Surgical Sciences, Città della Salute e della Scienza, University of Torino, Torino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
authors.affiliation: Urology, Fondazione Istituto San Raffaele-G. Giglio di Cefalù, Cefalù, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Savoca
authors.affiliation: Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000009:adverse effects*; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000628:therapy*
chemical_list: D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone