Cardiovascular complications in patients with advanced prostatic cancer treated by means of orchiectomy or polyestradiol phosphate

Mikkola, Arto; Aro, Jussi; Rannikko, S.; Oksanen, Hanna; Ruutu, Mirja

doi:10.1080/00365590510031228

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…However, the Mikkola study examined the incidence of CVS events and found that the rate of occurrence did not diminish significantly over the first 3 years of treatment. Instead, the risk remained higher among men with non-metastatic disease in the PEP group than in the orchidectomy group, but did not differ between groups for those with metastatic disease (Mikkola et al, 2005).…”

Section: Adverse Eventsmentioning

confidence: 76%

“…RRs shown are calculated from raw data presented in the publication and differ from those reported in the text, which were extracted from the Cox proportional hazards model reported. (Mikkola et al, 2005). The Henriksson trial found more events in the orchidectomy group (4 out of 16) than in the PEP group (1 out of 17) (Henriksson et al, 1999).…”

Section: Nature Of the Evidencementioning

confidence: 99%

“…After full assessment, three further reports of two previously included studies were identified in the review of effectiveness and safety (Mikkola et al, 2005(Mikkola et al, , 2007Hedlund et al, 2007). Two of these were full papers (Mikkola et al, 2005(Mikkola et al, , 2007 Figure 1 Study identification, retrieval and inclusion. (Hedlund et al, 2007).…”

Section: Nature Of the Evidencementioning

confidence: 99%

“…RRs calculated from raw data presented in the publication are shown in Figure 3. In this study, the authors retrospectively classified patients into those at high risk of CVS complications due to pretreatment vascular disease (patients with previous coronary heart disease, cerebral infarction, transient ischaemic attack or intermittent claudication), those with other pretreatment diseases associated with the risk of CVS events (patients with previous diabetes mellitus, hypertension, cardiac heart failure or rheumatoid arthritis), and those without any of the above pretreatment diseases (Mikkola et al, 2005). Within both the M0 and the M1 patient groups, the proportional hazards model found that the excess mortality in the PEP treatment arm was higher in those classified as having pretreatment vascular disease (M0: RR ¼ 3.48, 95% CI: 1.63, 7.44; P ¼ 0.001; M1: RR ¼ 3.13, 95% CI: 1.09, 9.00; P ¼ 0.035), but those with other pretreatment disease associated with CVS risk did not have significantly increased mortality (M0: RR ¼ 1.64, 95% CI: 0.59, 4.57; P ¼ 0.34; M1: RR ¼ 1.63, 95% CI: 0.40, 6.57; P ¼ 0.49) (Mikkola et al, 2007).…”

Section: Nature Of the Evidencementioning

confidence: 99%

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Parenteral oestrogen in the treatment of prostate cancer: a systematic review

et al. 2008

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The objectives of this study were to assess the effectiveness and safety of parenteral oestrogen in the treatment of prostate cancer, and to examine any dose relationship. A systematic review was undertaken. Electronic databases, published paper and internet resources were searched to locate published and unpublished studies with no restriction by language or publication date. Studies included were randomised controlled trials of parenteral oestrogen in patients with prostate cancer; other study designs were also included to examine dose -response. Study selection, appraisal, data extraction and quality assessment were performed by one reviewer and independently checked by another. Twenty trials were included in the review. The trials differed with regard to the included patients, formulation and dose of parenteral oestrogen, comparator used, outcome measures reported and the duration of follow-up. The results provide no evidence to suggest that parenteral oestrogen, in doses sufficient to produce castrate levels of testosterone, is less effective than luteinising hormone-releasing hormone (LHRH) or orchidectomy in controlling prostate cancer, or that it is consistently associated with an increase in cardiovascular mortality. Further well-conducted trials of parenteral oestrogen are required. A pilot randomised controlled trial comparing transdermal oestrogen to LHRH analogues in men with locally advanced or metastatic prostate cancer is underway in the United Kingdom.

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Section: Adverse Eventsmentioning

confidence: 76%

Section: Nature Of the Evidencementioning

confidence: 99%

Section: Nature Of the Evidencementioning

confidence: 99%

Section: Nature Of the Evidencementioning

confidence: 99%

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Parenteral oestrogen in the treatment of prostate cancer: a systematic review

et al. 2008

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“…or transdermal) administration of estrogen, which avoids hepatic enzyme induction. It also seems that a short-term but modest increase in cardiovascular morbidity (but not mortality) is compensated for by a long-term cardioprotective In patients with locally advanced prostatic cancer, PEP estrogen therapy is associated with a statistically significant higher risk of cardiovascular complications compared with orchidectomy (38). The relative risk of diabetes mellitus is increased in men treated with LHRHa by 44% and the relative risk of cardiovascular morbidity by 10-20%.…”

Section: Effects Of Cross-sex Hormone Treatment On Cardiovascular Heamentioning

confidence: 82%

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

114

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Objective: The incidence of heart disease increases with age, but is lower in women than in men up to 75 years. A protective effect of female sex hormones or, alternatively, acceleration in male heart disease by testosterone at younger ages, could explain this sex difference. In contrast with the above, male-to-female transsexual subjects (MtoF) treated with estrogens (Canti-androgens) show more cardiovascular pathology than female-to-male transsexual subjects (FtoM) receiving testosterone. Why MtoF suffer more frequently from cardiovascular disease than females is as yet unclear. The mode of cross-sex hormone treatment may be a factor, and, if so, it may need adaptations. Subjects and methods: Studies in transsexual people on the effects of cross-sex hormone treatment on surrogate cardiovascular risks and on clinical endpoints were reviewed. With regard to MtoF, a parallel was sought with men with prostate cancer, undergoing androgen deprivation and estrogen administration. Results: Exposure of FtoM to testosterone was not associated with a strong increase in cardiovascular events. Aging and pre-existing cardiovascular pathology contributed to the risk of cardiovascular disease in MtoF. Use of the synthetic biopotent compound ethinyl estradiol in a dose two to four times of oral contraceptives increased cardiovascular risk substantially. The route of administration of estrogens (oral vs transdermal) may have impacted on the risks. Conclusion: MtoF should not be treated with oral ethinyl estradiol. Transdermal estrogens are probably safer than oral estrogens. Pre-existing cardiovascular risks should be taken into consideration when prescribing and choosing the type of estrogens in crosssex hormone administration (oral vs transdermal). In addition, risk factors, as they emerge with aging, should be addressed.

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Ten‐year survival and cardiovascular mortality in patients with advanced prostate cancer primarily treated by intramuscular polyestradiol phosphate or orchiectomy

Mikkola¹,

Aro²,

Rannikko³

et al. 2007

The Prostate

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Cardiovascular complications in patients with advanced prostatic cancer treated by means of orchiectomy or polyestradiol phosphate

Abstract: In patients with locally advanced prostatic cancer, PEP therapy is associated with a statistically significantly higher risk of CV complications compared to OE.

Cited by 9 publications

References 30 publications

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Ten‐year survival and cardiovascular mortality in patients with advanced prostate cancer primarily treated by intramuscular polyestradiol phosphate or orchiectomy

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