Effects of androgen deprivation therapy on elderly men with high-risk prostate cancer: PROSARC observational study | Actas Urológicas Españolas (English Edition)

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Legido-Gómez, S. Rico-Marco, M.V. Lorenzo-Sánchez, S. Navarro-Jiménez, M.A. Tárraga-Honrubia, J. Martínez-Ruiz, J.M. Giménez-Bachs, M.J. Donate-Moreno, I. Díaz de Mera-Sánchez-Migallón, M. Segura-Martín, R. Alcantud-Córcoles, P. Abizanda-Soler, A.S. Salinas-Sánchez" "autores" => array:13 [ 0 => array:4 [ "nombre" => "Ó." "apellidos" => "Legido-Gómez" "email" => array:1 [ 0 => "oscarlg9@hotmail.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Rico-Marco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.V." "apellidos" => "Lorenzo-Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "S." 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"apellidos" => "Segura-Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 10 => array:3 [ "nombre" => "R." "apellidos" => "Alcantud-Córcoles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 11 => array:3 [ "nombre" => "P." "apellidos" => "Abizanda-Soler" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 12 => array:3 [ "nombre" => "A.S." "apellidos" => "Salinas-Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Urología, Hospital General Universitario de Albacete, Albacete, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Geriatría, Hospital Universitario Nuestra Señora del Perpetuo Socorro, Albacete, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectos de la privación androgénica en cáncer de próstata de alto riesgo en ancianos: estudio observacional PROSARC" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1585 "Ancho" => 1258 "Tamanyo" => 287819 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Dual X-ray absorptiometry (DXA) at baseline and after 6 months of androgen deprivation." ] ] ] "textoCompleto" => "IntroductionProstatic carcinoma (PC) is the second most frequent tumor in men, globally affecting almost 1.6 million individuals per year.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> With more than 300,000 deaths/year, it is the fifth leading cause of cancer-related death.One in 8 men is at risk of developing PC. Most are diagnosed at over 60 years of age<a class="elsevierStyleCrossRef" href="#bib0005">1</a> and in localized stages.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> The risk of PC becomes higher with age and may be influenced by increasingly frequent unhealthy lifestyle habits: unhealthy diet, sedentary lifestyle, obesity and smoking.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> The incidence and mortality of PC has increased over the last three decades, and this trend is expected to continue owing to the aging of the world’s population.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>The treatment of PC depends on the stage<a class="elsevierStyleCrossRef" href="#bib0010">2</a> and clinicopathological characteristics of the tumor, as they determine different risk groups (very low – very high risk).<a class="elsevierStyleCrossRef" href="#bib0020">4</a>Androgen levels, which are usually elevated within the tumor,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> promote tumor progression. Aiming to reduce the effects of these high levels and to control excessive activation of the androgen receptor signaling pathway, hormonal treatment<a class="elsevierStyleCrossRef" href="#bib0005">1</a> –androgen deprivation (ADT) with hormones that block androgen activity and new androgen receptor axis-targeted agents (ARTAs)<a class="elsevierStyleCrossRef" href="#bib0005">1</a>– is used.Localized tumors can be managed with curative intent treatment including local treatment.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2,5</a> Localized and locally advanced tumors not suitable for local treatment also receive ADT.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> In advanced (metastatic) tumors, ADT+ARTA combined with chemotherapy is used in some cases as palliative treatment<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> achieving great benefit.Fifty percent of patients with PC will require hormone deprivation for their disease, and the use of ARTAs in early stages increases exposure to the anti-androgenic effect.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> ADT can improve overall survival (OS) and progression-free survival (PFS).<a class="elsevierStyleCrossRefs" href="#bib0030">6,8–10</a> However, despite the demonstrated efficacy of androgen deprivation, it is also associated with various toxicities such as obesity, metabolic syndrome, cardiovascular disease (especially in elderly individuals), diabetes, osteoporosis, bone fractures,<a class="elsevierStyleCrossRef" href="#bib0055">11</a> and reduced muscle mass, among others.<a class="elsevierStyleCrossRefs" href="#bib0025">5,9,12</a> For example, an increased risk of cardiovascular disease has been observed in patients on ADT with gonadotropin-releasing hormone (GnRH) agonists of 21% (HR 1.21; 95% CI, 1.18–1.25). This is particularly relevant during the first 6 months of treatment and in patients who have experienced two or more cardiovascular events prior to initiation of therapy.<a class="elsevierStyleCrossRef" href="#bib0065">13</a>On the other hand, the loss of muscle mass derived from any oncological treatment has been shown to be a poor prognostic factor in several tumors such as ovarian<a class="elsevierStyleCrossRef" href="#bib0070">14</a> and prostate,<a class="elsevierStyleCrossRefs" href="#bib0050">10,15,16</a> among others. It also has a negative impact on the quality of life (QoL) of adult cancer patients (mostly global and physical functioning domains).<a class="elsevierStyleCrossRef" href="#bib0085">17</a>In view of the possible clinical implications of the effects associated with androgen deprivation in PC, these should be identified and deeply studied at the start of treatment in order to develop preventive strategies (nutritional, training, etc.).The aim of this prospective study is to quantify the prevalence of osteoporosis, frailty, and sarcopenia in elderly patients with PC before and after treatment with ADT. We present data from an interim analysis of the study evaluating the appearance or worsening of these conditions as a consequence of androgen deprivation.MethodsPROSARC is an observational, prospective study carried out in the two hospitals of the Albacete University Hospital Complex: General University Hospital and Nuestra Señora del Perpetuo Socorro University Hospital.Inclusion criteria were patients aged ≥70 years, high-risk PC, not candidates for local treatment, and scheduled initiation of ADT (according to clinical practice) after approval of the study.During recruitment (started in May 2022 and scheduled to end in May 2025), urology service specialists will include all those patients eligible for the study who agree to participate.Data were collected from the visits registered in the medical record (before [baseline situation] and 6 months after the start of deprivation) after inclusion of the first patient and will end one month after the follow-up visit at 6 months of treatment of the last patient included. Variables collected included PC characteristics (stage, prognostic group [International Society of Urological Pathology (ISUP)], PSA at diagnosis), and patient characteristics (Charlson comorbidity index, frailty [Fried criteria], osteoporosis [dual X-ray absorptiometry (DXA)], sarcopenia [according to European Working Group on Sarcopenia in Older People 2 (EWGSOP2)], percentage of fat mass, and decreased muscle mass [ratio of appendicular muscle mass (AMM to height2<7kg/m2), as well as additional treatments for metastatic PC.The GRANMO online calculator was used to calculate the required sample size, selecting the proportions and repeated measures option, and considering the data corresponding to an intermediate analysis with 12 subjects, since there are no data in the literature that allow us to make an initial estimate. Accepting an alpha risk of 0.05 and a beta risk of 0.2 in a bilateral contrast, 42 subjects are required assuming that the initial proportion of events (low muscle mass) is 75% and 99% after 6 months of ADT. A loss-to-follow-up rate of 15% was estimated. This interim analysis did not modify the structure, design, or objectives of the study.The data were entered, stored, and analyzed using SPSS version 25.0 (Statistical Package for Social Sciences, version 25.0. Armonk, NY: IBM Corp.). We checked whether the quantitative variables were distributed according to a normal distribution (Kolmogorov–Smirnov test) and then applied the measures of central tendency and dispersion corresponding to the descriptive study, as well as using the appropriate statistical estimators.A comparative analysis was performed between subjects before and after treatment (6 months) for each of the variables using mean comparison tests for paired samples (Wilcoxon test) and proportions (McNemar test). Differences with p less than 0.05 were considered statistically significant.The study was carried out in accordance with local regulations and was approved by the drug research ethics committee of Albacete. All patients gave their written consent to participate in the study.ResultsTwenty-five patients were included before the data cutoff date (1-May-2023); 12 with evaluation at 6 months after ADT initiation. The entire selected study-eligible sample agreed to participate. The characteristics of patients and PC are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Prior to ADT, the prevalence of prefrailty/frailty (67.7%), sarcopenia (66.7%) and osteoporosis (25%) was high (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Subjects with localized disease did not receive local treatment because their life expectancy was less than 10 years. According to clinical criteria, some patients were referred to the Geriatrics department for a comprehensive geriatric assessment in order to identify reversible alterations.After 6 months of treatment, there were no statistically significant changes in frailty and sarcopenia, nor variation in osteoporosis or comorbidity. In the 3 subjects in whom osteoporosis was detected, semiannual denosumab was started.Regarding obesity, there were slight variations in body mass index (BMI), but without statistical significance. A significant reduction in the mean value of appendicular muscle mass was observed-, variations in patient height during treatment were ruled out. The percentage of patients with decreased muscle mass went from 75% to 100%, without statistical significance (p=0.250). The mean value calculated to establish this situation of decreased muscle mass was significantly reduced from 6.1 to 5.6. The increase in the percentage of fat mass was also significant, although slight (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the increase in fat mass (yellow color) and the decrease in muscle mass (red color) after 6 months of ADT, measured by dual X-ray absorptiometry (DXA).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>DiscussionAccording to the preliminary data from our study, more than two thirds of elderly patients with high-risk PC are in a pre-frailty/frailty situation, and with sarcopenia. Treatment with ADT (6 months) did not lead to significant changes in frailty, sarcopenia, comorbidity, osteoporosis, or obesity (assessed as changes in BMI). However, there was a significant loss of muscle mass and a slight increase in fat mass.The mean age of the PC patients analyzed (84.31 years) was higher than that of the Spanish population of SHARE (Survey of Health, Ageing and Retirement in Europe) (n=1765). With a mean age of 75.2 years, it was classified as pre-fragile (73%) and the rest as frail (27.2%), according to the Fried criteria. If we consider the use of other frailty criteria (multidimensional prognostic index [MPI])<a class="elsevierStyleCrossRef" href="#bib0090">19</a> in a meta-analysis of data from 56,407 subjects of a similar age to the Spanish SHARE sample (mean, 78.6 years), the proportion of pre-frailty and frailty was 36.4% vs. 26.8%, respectively.The higher proportion of prefrailty vs. frailty observed in both studies was seen in our patients with PC (50% vs. 16.7%), even at a higher age (84.31 years).Additional treatment to ADT in metastatic stage is evaluated in a multidisciplinary tumor board. It was not considered in three cases due to comorbidities of the individuals. In the remaining four, an ARTA was prescribed (two patients with low-risk disease and two with high-risk disease). None of the two high-risk subjects were candidates for chemotherapy.The high percentage of osteoporosis (25%) detected in our elderly population reflects the predisposition for osteoporosis and sarcopenia in this age range (>60 years), owing to the progressive bone mineral density and muscle mass loss.<a class="elsevierStyleCrossRef" href="#bib0095">20</a> However, this is at the lower limit of the figures described in patients diagnosed with PC (25%–40%).<a class="elsevierStyleCrossRef" href="#bib0100">21</a> Nevertheless, we did not observe differences in bone mineral density, despite the fact that ADT causes detectable reductions 6–9 months after starting treatment (5%–10% decline in the first year).<a class="elsevierStyleCrossRef" href="#bib0100">21</a> Detection of these reductions may require more time.With respect to sarcopenia, there is currently no consensus definition, with different cut off points and clinical criteria. Those proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and its 2018 updated version (EWGSOP2)<a class="elsevierStyleCrossRef" href="#bib0105">22</a> are the most relevant. These criteria include low muscle mass (a mandatory criterion), low muscle strength and low physical performance.<a class="elsevierStyleCrossRef" href="#bib0110">23</a> There are very few papers measuring the prevalence of sarcopenia in patients with PC, with variable results ranging between 3.2%<a class="elsevierStyleCrossRef" href="#bib0115">24</a> and 29.2%<a class="elsevierStyleCrossRef" href="#bib0120">25</a> among patients under ADT and 2% in those without hormone blockade.<a class="elsevierStyleCrossRef" href="#bib0120">25</a> In our patients, the prevalence of sarcopenia at baseline was 66%. The large difference in this prevalence could be due to the small sample size, lower mean age (69 years) or by the fact that almost all of them had already been treated for PC, either surgically or with RT, thus patients with advanced disease were not considered. Data on the incidence of sarcopenia in relation to ADT are lacking, and contrary to what might be expected, we observed less sarcopenia after 6 months of treatment.The baseline status of our patients also reflects the effect of age on muscle mass, with three out of four patients presenting low muscle mass. After 6 months of treatment, all patients presented decreased mass, with significant differences.Although few articles analyze the impact of current treatments for metastatic PC on the loss of muscle mass,<a class="elsevierStyleCrossRef" href="#bib0125">26</a> it seems logical to think that there is an accelerated decrease in muscle mass as the anti-androgenic effect intensifies with respect to those patients who only receive ADT.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>Although this decrease would suggest an increase in sarcopenia, our results show a decrease in sarcopenia. This result could be due to the consideration of muscle strength and function to determine sarcopenia, as well as to the small sample size and measurement period (6 months from the start of treatment). Therefore, we will not consider changes regarding sarcopenia.The increased risk of falls, reduced mobility, and loss of QoL as a result of muscle mass loss,<a class="elsevierStyleCrossRef" href="#bib0080">16</a> requires the implementation of measures to reduce the impact of this treatment in patients with PC.One of these measures could include exercise training, which has been shown to improve body composition, muscle strength and QoL in this type of patient.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> It has been described that physical exercise, both resistance and aerobic training, can be useful to prevent the negative impact of ADT on bones and muscles.<a class="elsevierStyleCrossRefs" href="#bib0080">16,27</a> Additionally, promoting standardized and supervised training programs of increasing intensity focused on the upper and lower body would be of great benefit for these patients.Improved body composition through exercise could also benefit the (significant) effect we observed in our patients on the previously described increase in fat mass.<a class="elsevierStyleCrossRef" href="#bib0075">15</a>The care of bones and muscles may benefit from lifestyle changes in these patients.<a class="elsevierStyleCrossRef" href="#bib0130">27</a> Other measures that can be taken to avoid/reduce the impact of ADT on bone health are to ensure an adequate intake of calcium (1000–1200mg per day, preferably from the diet), as well as vitamin D (800–1600IU per day from diet or exposure to sunlight) considering supplements if these sources are not sufficient. The use of bisphosphonates and denosumab can be indicated in case of previous osteoporotic fractures, findings of osteoporosis on DXA or high risk of fracture according to the FRAX® tool.Therefore, bone health may require calcium and vitamin D supplementation and bisphosphonates or denosumab.<a class="elsevierStyleCrossRefs" href="#bib0035">7,27,28</a>For the prevention and management of these effects, the participation of a multidisciplinary team including nutritionists, physiotherapists, physical activity, and sport sciences experts, as well as rehabilitation specialists would be necessary to achieve the implementation of various measures. Oncology nurses could assist greatly in the accomplishment and monitoring of these actions. Their role in the education of patients and caregivers as well as in the follow-up of patients’ QoL has been described.<a class="elsevierStyleCrossRef" href="#bib0140">29</a>ConclusionsAndrogen deprivation (ADT; 6 months) in patients with high-risk PC, advanced age and a prevalence of osteoporosis, sarcopenia, and considerable frailty, produces a decrease in muscle mass without impacting the incidence of the adverse effects under study.LimitationsThe main limitation of this study is that these are preliminary results with a small sample of subjects (n=12), justified by the slow recruitment. Therefore, the results obtained should be interpreted with caution. This problem is expected to be solved when the recruitment of the estimated sample required is finalized and all the biannual evaluations are completed.The duration of the hormonal treatment in this study, 6 months, should also be considered. Patients usually receive this treatment for longer periods, even lasting several years, with more pronounced long-term alterations being expected.Despite the limitations and the preliminary nature of the data, they explore a currently unknown area and, and will shed light on the problem within the urological community.FundingThis research has not received specific support from public sector agencies, commercial sector, or non-profit entities.Conflicts of interestNone." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres2160963" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1833478" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2160962" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1833477" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Limitations" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-11-14" "fechaAceptado" => "2023-12-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1833478" "palabras" => array:4 [ 0 => "Prostate cancer" 1 => "Androgen deprivation" 2 => "Frailty" 3 => "Muscle mass" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1833477" "palabras" => array:4 [ 0 => "Cáncer de próstata" 1 => "Privación androgénica" 2 => "Fragilidad" 3 => "Masa muscular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionProstatic carcinoma (PC) is a frequent neoplasm in elderly patients. Although androgen deprivation is associated with survival benefits, it is also related to adverse effects such as osteoporosis, frailty, or sarcopenia, which can negatively affect the patient’s quality of life. This study aims to quantify and evaluate the prevalence of osteoporosis, frailty, or sarcopenia in elderly PC patients before and after androgen deprivation. We present data from an interim analysis. Materials and methodsPROSARC is a national (Spain) prospective observational study (May-2022–May-2025) still in progress in 2 hospitals. It includes patients with high-risk PC, aged ≥70 years, non-candidates for local treatment and scheduled to start androgen deprivation therapy. The following variables are analyzed: comorbidity, frailty (Fried frailty phenotype criteria), osteoporosis, sarcopenia (EWGSOP2), fat mass and muscle mass, before treatment and after 6 months of follow-up. ResultsA 6-month follow-up was completed by 12/25 included patients (mean age, 84 years), with a high baseline prevalence of pre-frailty/frailty (67.7%), sarcopenia (66.7%) and osteoporosis (25%). Treatment did not significantly alter these variables or comorbidity. We observed changes in body mass index (p=0.666), decreased mean value of appendicular muscle mass (p=0.01) and increased percentage of fat mass (p=0.012). ConclusionIn patients with high-risk PC, advanced age and a considerable prevalence of osteoporosis, frailty and sarcopenia, androgen deprivation (ADT; 6 months) produces decreased muscle mass without impact on the incidence of the known adverse effects of androgen deprivation." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl carcinoma prostático (CP) es una neoplasia frecuente en pacientes de edad avanzada. La privación androgénica, con beneficio en supervivencia, se relaciona con efectos adversos tales como osteoporosis, fragilidad o sarcopenia, que pueden impactar negativamente en la calidad de vida del paciente. Este estudio pretende cuantificar y evaluar el estado de osteoporosis, fragilidad o sarcopenia en pacientes con CP de edad avanzada antes y después de la privación androgénica. Presentamos datos de un análisis intermedio. Materiales y métodosEstudio nacional (España) observacional prospectivo, PROSARC, aún en marcha (mayo del 2022-mayo del 2025) en 2 hospitales. Incluye a pacientes con CP de alto riesgo, ≥ 70 años, no candidatos a tratamiento local e inicio programado de privación androgénica. Se analizan las siguientes variables: comorbilidad, fragilidad (criterios de Fried), osteoporosis, sarcopenia (EWGSOP2), masa grasa y masa muscular, antes del tratamiento y tras 6 meses de seguimiento. ResultadosCompletaron un seguimiento de 6 meses 12/25 pacientes incluidos (edad media, 84 años), con una elevada prevalencia basal de prefragilidad/fragilidad (67,7%), sarcopenia (66,7%) y osteoporosis (25%). El tratamiento no varió significativamente estas variables ni la comorbilidad. Se observaron cambios en el índice de masa corporal (p=0,666), reducción del valor medio de la masa muscular apendicular (p=0,01) e incremento del porcentaje de masa grasa (p=0,012). ConclusiónLa privación androgénica (6 meses) en pacientes con CP de alto riesgo, edad avanzada y una prevalencia considerable de osteoporosis, fragilidad y sarcopenia, produce disminución de masa muscular sin que ello repercuta en la incidencia de los efectos adversos de la privación androgénica estudiados." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1585 "Ancho" => 1258 "Tamanyo" => 287819 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Dual X-ray absorptiometry (DXA) at baseline and after 6 months of androgen deprivation." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0155" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "SD: standard deviation; EWGSOP2: European Working Group on Sarcopenia in Older People 2; GG: prognostic grade group; BMI: body mass index; ISUP: International Society of Urological Pathology; AMM: appendicular muscle mass; PSA: prostate specific antigen; IQR: interquartile range; ADT: androgen deprivation therapy." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N=12 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 months \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84,31 (6,16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA (ng/ml) at diagnosis, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41,9 (19,12–69,91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GG_ISUP, N (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (41,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage of disease, N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Localized \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (41,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Metastatic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (58,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Metastatic disease, N (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Low risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (42,85) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High grade \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (57,15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ADT additional treatment, N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Apalutamide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enzalutamide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI (kg/m2), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26,11 (3,63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26,27 (3,39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,666 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Charlson Index, N(%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (41,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (41,7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (8,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Frailty criteria (L. Fried), N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,091 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (16.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prefrailty \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (58,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Frailty \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (16,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Osteoporosis, N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sarcopenia criteria (EWGSOP2), N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,222 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No sarcopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sarcopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (16,7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Severe sarcopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (41,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (33,3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Loss of muscle mass<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>, N (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,250 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AMM (kg), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17,3 (2,8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15,91 (2,08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AMM/height2 (kg/m2), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,1 (0,94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5,6 (0,62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Difference (kg/m2), mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,49 (0,47)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">% Fat mass, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33,78 (6,52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36,92 (4,67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,012 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3560979.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Loss of muscle mass is considered if AMM/height2=<7kg/m2." ] ] ] "descripcion" => array:1 [ "en" => "Sociodemographic and oncologic characteristics of subjects and 6-month evaluation after ADT initiation." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recent advances and future perspectives in the therapeutics of prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.L. Varaprasad" 1 => "V.K. Gupta" 2 => "K. Prasad" 3 => "E. Kim" 4 => "M.B. Tej" 5 => "P. Mohanty" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s40164-023-00444-00449" "Revista" => array:5 [ "tituloSerie" => "Exp Hematol Oncol." "fecha" => "2023" "volumen" => "12" "paginaInicial" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37740236" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of age at diagnosis of de novo metastatic prostate cancer on survival" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Bernard" 1 => "C. Burnett" 2 => "C.J. Sweeney" 3 => "J.R. Rider" 4 => "S.S. Sridhar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.32630" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2020" "volumen" => "126" "paginaInicial" => "986" "paginaFinal" => "993" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31769876" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global burden of prostate cancer and Association with Socioeconomic Status, 1990–2019: a systematic analysis from the global burden of disease study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Zhang" 1 => "G. Cao" 2 => "F. Wu" 3 => "Y. Wang" 4 => "Z. Liu" 5 => "H. Hu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s44197-023-00103-00106" "Revista" => array:6 [ "tituloSerie" => "J Epidemiol Glob Health" "fecha" => "2023" "volumen" => "13" "paginaInicial" => "407" "paginaFinal" => "421" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37147513" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "National Comprehensive Cancer Network (NCCN) risk classification in predicting biochemical recurrence after radical prostatectomy: a retrospective cohort study in Chinese prostate cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Xu" 1 => "Y. Zhu" 2 => "B. Dai" 3 => "D.W. Ye" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/aja.aja_52_18" "Revista" => array:6 [ "tituloSerie" => "Asian J Androl" "fecha" => "2018" "volumen" => "20" "paginaInicial" => "551" "paginaFinal" => "554" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30027928" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Androgen deprivation therapy in patients with localized disease: Comparison with curative intent treatments and time to castration resistance. Results of the Spanish Prostate Cancer Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Garcia-Rodriguez" 1 => "J.M. Fernandez-Gomez" 2 => "J.M. Cozar" 3 => "B. Miñana" 4 => "F. Gomez-Veiga" 5 => "A. Rodriguez-Antolin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2019.06.006" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp (Engl Ed)" "fecha" => "2020" "volumen" => "44" "paginaInicial" => "156" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32113829" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The treatment landscape of metastatic prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Yamada" 1 => "H. Beltran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.canlet.2021.06.010" "Revista" => array:6 [ "tituloSerie" => "Cancer Lett" "fecha" => "2021" "volumen" => "519" "paginaInicial" => "20" "paginaFinal" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34153403" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How to improve the quality of life of patients with prostate cancer treated with hormone therapy?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Turco" 1 => "L. Di Prima" 2 => "C. Pisano" 3 => "S. Poletto" 4 => "M. De Filippis" 5 => "V. Crespi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/rru.s350793" "Revista" => array:7 [ "tituloSerie" => "Res Rep Urol" "fecha" => "2023" "volumen" => "15" "paginaInicial" => "9" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36698681" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S147444221600034X" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of novel androgen receptor axis-targeted therapies with diarrhea in patients with prostate cancer: a Bayesian network analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Xiong" 1 => "H. Xu" 2 => "S. Wang" 3 => "X. Liao" 4 => "X. Yi" 5 => "K. Jin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fmed.2021.800823" "Revista" => array:5 [ "tituloSerie" => "Front Med (Lausanne)" "fecha" => "2021" "volumen" => "8" "paginaInicial" => "800823" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35141248" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Yuan" 1 => "Y. Wang" 2 => "X. Xiao" 3 => "X. Zhang" 4 => "M. Jing" 5 => "H. Kamecki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/tau-23-272" "Revista" => array:6 [ "tituloSerie" => "Transl Androl Urol" "fecha" => "2023" "volumen" => "12" "paginaInicial" => "1336" "paginaFinal" => "1350" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37680229" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of the sarcopenic effect of androgen receptor-axis-targeted agents vs. androgen deprivation alone in patients with metastatic prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Lawen" 1 => "K. Masoumi-Ravandi" 2 => "R.A. Rendon" 3 => "L. Connor" 4 => "R.J. Mason" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5489/cuaj.8245" "Revista" => array:6 [ "tituloSerie" => "Can Urol Assoc J" "fecha" => "2023" "volumen" => "17" "paginaInicial" => "274" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37581552" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Androgen deprivation in prostate cancer and the long-term risk of fracture" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Ojeda" 1 => "M. Lloret" 2 => "A. Naranjo" 3 => "F. Déniz" 4 => "N. Chesa" 5 => "C. Domínguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2017.01.005" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "491" "paginaFinal" => "496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28259363" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Androgen deprivation therapy, hypogonadism and cardiovascular toxicity in men with advanced prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.S. Gheorghe" 1 => "A.S. Hodorogea" 2 => "A. Ciobanu" 3 => "I.T. Nanea" 4 => "A.C.D. Gheorghe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/curroncol28050289" "Revista" => array:6 [ "tituloSerie" => "Curr Oncol" "fecha" => "2021" "volumen" => "28" "paginaInicial" => "3331" "paginaFinal" => "3346" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34590590" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. O’Farrell" 1 => "H. Garmo" 2 => "L. Holmberg" 3 => "J. Adolfsson" 4 => "P. Stattin" 5 => "M. Van Hemelrijck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.2014.59.1792" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2015" "volumen" => "33" "paginaInicial" => "1243" "paginaFinal" => "1251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25732167" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Muscle loss during primary debulking surgery and chemotherapy predicts poor survival in advanced-stage ovarian cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.Y. Huang" 1 => "Y.C. Yang" 2 => "T.C. Chen" 3 => "J.R. Chen" 4 => "Y.J. Chen" 5 => "M.H. Wu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jcsm.12524" "Revista" => array:6 [ "tituloSerie" => "J Cachexia Sarcopenia Muscle" "fecha" => "2020" "volumen" => "11" "paginaInicial" => "534" "paginaFinal" => "546" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31999069" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Muscle loss during androgen deprivation therapy is associated with higher risk of non-cancer mortality in high-risk prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.K. Chiang" 1 => "W.K. Tsai" 2 => "A.W. Chiu" 3 => "J.B. Lin" 4 => "F.Y. Yang" 5 => "J. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fonc.2021.722652" "Revista" => array:5 [ "tituloSerie" => "Front Oncol" "fecha" => "2021" "volumen" => "11" "paginaInicial" => "722652" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34604058" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resistance exercise counteracts the impact of androgen deprivation therapy on muscle characteristics in cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Overkamp" 1 => "L.H.P. Houben" 2 => "T. Aussieker" 3 => "J.M.X. van Kranenburg" 4 => "P.J.M. Pinckaers" 5 => "U.R. Mikkelsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/clinem/dgad245" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2023" "volumen" => "108" "paginaInicial" => "e907" "paginaFinal" => "e915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37161470" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between skeletal muscle mass and quality of life in adults with cancer: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Hanna" 1 => "K. Nguo" 2 => "K. Furness" 3 => "J. Porter" 4 => "C.E. Huggins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jcsm.12928" "Revista" => array:7 [ "tituloSerie" => "J Cachexia Sarcopenia Muscle" "fecha" => "2022" "volumen" => "13" "paginaInicial" => "839" "paginaFinal" => "857" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35156342" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165587616301744" "estado" => "S300" "issn" => "01655876" ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Veronese" 1 => "C. Custodero" 2 => "A. Cella" 3 => "J. Demurtas" 4 => "S. Zora" 5 => "S. Maggi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arr.2021.101498" "Revista" => array:5 [ "tituloSerie" => "Ageing Res Rev" "fecha" => "2021" "volumen" => "72" "paginaInicial" => "101498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34700009" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis in older adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Bouvard" 1 => "C. Annweiler" 2 => "E. Legrand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jbspin.2021.105135" "Revista" => array:5 [ "tituloSerie" => "Joint Bone Spine" "fecha" => "2021" "volumen" => "88" "paginaInicial" => "105135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33486108" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone loss induced by cancer treatments in breast and prostate cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Castañeda" 1 => "A. Casas" 2 => "A. González-Del-Alba" 3 => "G. Martínez-Díaz-Guerra" 4 => "X. Nogués" 5 => "C. Ojeda Thies" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12094-022-02872-1" "Revista" => array:7 [ "tituloSerie" => "Clin Transl Oncol" "fecha" => "2022" "volumen" => "24" "paginaInicial" => "2090" "paginaFinal" => "2106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35779210" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165587615000646" "estado" => "S300" "issn" => "01655876" ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcopenia: revised European consensus on definition and diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Cruz-Jentoft" 1 => "G. Bahat" 2 => "J. Bauer" 3 => "Y. Boirie" 4 => "O. Bruyère" 5 => "T. Cederholm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ageing/afy169" "Revista" => array:6 [ "tituloSerie" => "Age Ageing" "fecha" => "2019" "volumen" => "48" "paginaInicial" => "16" "paginaFinal" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30312372" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Definición y evolución del concepto de sarcopenia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Sánchez Tocino" 1 => "S. Cigarrán" 2 => "P. Ureña" 3 => "M. González Casaus" 4 => "S. Mas-Fontao" 5 => "C. Gracia Iguacel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nefro.2023.08.001" "Revista" => array:2 [ "tituloSerie" => "Nefrología" "fecha" => "2023" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does use of androgen deprivation therapy (ADT) in men with prostate cancer increase the risk of sarcopenia?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.J. Owen" 1 => "R.M. Daly" 2 => "J. Dalla Via" 3 => "N.L. Mundell" 4 => "P.M. Livingston" 5 => "T. Rantalainen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00223-019-00586-1" "Revista" => array:6 [ "tituloSerie" => "Calcif Tissue Int" "fecha" => "2019" "volumen" => "105" "paginaInicial" => "403" "paginaFinal" => "411" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31317232" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Presence of sarcopenic obesity and evaluation of the associated muscle quality in Japanese older men with prostate cancer undergoing androgen deprivation therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Kimura" 1 => "M. Yamada" 2 => "S. Ohji" 3 => "D. Ishiyama" 4 => "N. Nishio" 5 => "Y. Otobe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jgo.2019.03.017" "Revista" => array:6 [ "tituloSerie" => "J Geriatr Oncol" "fecha" => "2019" "volumen" => "10" "paginaInicial" => "835" "paginaFinal" => "838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30956136" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Fizazi" 1 => "N. Tran" 2 => "L. Fein" 3 => "N. Matsubara" 4 => "A. Rodriguez-Antolin" 5 => "B.Y. Alekseev" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1704174" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2017" "volumen" => "377" "paginaInicial" => "352" "paginaFinal" => "360" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28578607" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse effects of androgen deprivation therapy in patients with prostate cancer: focus on muscle and bone health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Bargiota" 1 => "A. Oeconomou" 2 => "I. Zachos" 3 => "M.L.L.P. Samarinas" 4 => "V. Tzortzis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Buon" "fecha" => "2020" "volumen" => "25" "paginaInicial" => "1286" "paginaFinal" => "1294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32862568" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A multidisciplinary consensus statement on the optimal pharmacological treatment for metastatic hormone-sensitive prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Borque-Fernando" 1 => "M.A. Calleja-Hernández" 2 => "J.M. Cózar-Olmo" 3 => "A. Gómez-Iturriaga" 4 => "D.A. Pérez-Fentes" 5 => "J. Puente-Vázquez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuroe.2022.12.004" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp (Engl Ed)" "fecha" => "2023" "volumen" => "47" "paginaInicial" => "111" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36720305" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nursing considerations for androgen deprivation therapy and bone health in men affected by prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.G. Cope" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.soncn.2022.151271" "Revista" => array:5 [ "tituloSerie" => "Semin Oncol Nurs" "fecha" => "2022" "volumen" => "38" "paginaInicial" => "151271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35491331" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000004800000004/v4_202406070649/S2173578624000192/v4_202406070649/en/main.assets" "Apartado" => array:4 [ "identificador" => "6274" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004800000004/v4_202406070649/S2173578624000192/v4_202406070649/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578624000192?idApp=UINPBA00004N"]

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Original article

Effects of androgen deprivation therapy on elderly men with high-risk prostate cancer: PROSARC observational study

Efectos de la privación androgénica en cáncer de próstata de alto riesgo en ancianos: estudio observacional PROSARC

Ó. Legido-Gómeza,

Corresponding author

oscarlg9@hotmail.es

Corresponding author.

, S. Rico-Marcoa, M.V. Lorenzo-Sáncheza, S. Navarro-Jiméneza, M.A. Tárraga-Honrubiaa, J. Martínez-Ruiza, J.M. Giménez-Bachsa, M.J. Donate-Morenoa, I. Díaz de Mera-Sánchez-Migallóna, M. Segura-Martína, R. Alcantud-Córcolesb, P. Abizanda-Solerb, A.S. Salinas-Sáncheza

a Servicio de Urología, Hospital General Universitario de Albacete, Albacete, Spain

b Servicio de Geriatría, Hospital Universitario Nuestra Señora del Perpetuo Socorro, Albacete, Spain

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        "titulo" => "Efectos de la privaci&#243;n androg&#233;nica en c&#225;ncer de pr&#243;stata de alto riesgo en ancianos&#58; estudio observacional PROSARC"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dual X-ray absorptiometry &#40;DXA&#41; at baseline and after 6 months of androgen deprivation&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Prostatic carcinoma &#40;PC&#41; is the second most frequent tumor in men&#44; globally affecting almost 1&#46;6 million individuals per year&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> With more than 300&#44;000 deaths&#47;year&#44; it is the fifth leading cause of cancer-related death&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">One in 8 men is at risk of developing PC&#46; Most are diagnosed at over 60 years of age<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and in localized stages&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The risk of PC becomes higher with age and may be influenced by increasingly frequent unhealthy lifestyle habits&#58; unhealthy diet&#44; sedentary lifestyle&#44; obesity and smoking&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The incidence and mortality of PC has increased over the last three decades&#44; and this trend is expected to continue owing to the aging of the world&#8217;s population&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The treatment of PC depends on the stage<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and clinicopathological characteristics of the tumor&#44; as they determine different risk groups &#40;very low &#8211; very high risk&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Androgen levels&#44; which are usually elevated within the tumor&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> promote tumor progression&#46; Aiming to reduce the effects of these high levels and to control excessive activation of the androgen receptor signaling pathway&#44; hormonal treatment<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> &#8211;androgen deprivation &#40;ADT&#41; with hormones that block androgen activity and new androgen receptor axis-targeted agents &#40;ARTAs&#41;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#8211; is used&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Localized tumors can be managed with curative intent treatment including local treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;5</span></a> Localized and locally advanced tumors not suitable for local treatment also receive ADT&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In advanced &#40;metastatic&#41; tumors&#44; ADT<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ARTA combined with chemotherapy is used in some cases as palliative treatment<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> achieving great benefit&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Fifty percent of patients with PC will require hormone deprivation for their disease&#44; and the use of ARTAs in early stages increases exposure to the anti-androgenic effect&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> ADT can improve overall survival &#40;OS&#41; and progression-free survival &#40;PFS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;8&#8211;10</span></a> However&#44; despite the demonstrated efficacy of androgen deprivation&#44; it is also associated with various toxicities such as obesity&#44; metabolic syndrome&#44; cardiovascular disease &#40;especially in elderly individuals&#41;&#44; diabetes&#44; osteoporosis&#44; bone fractures&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and reduced muscle mass&#44; among others&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;9&#44;12</span></a> For example&#44; an increased risk of cardiovascular disease has been observed in patients on ADT with gonadotropin-releasing hormone &#40;GnRH&#41; agonists of 21&#37; &#40;HR 1&#46;21&#59; 95&#37; CI&#44; 1&#46;18&#8211;1&#46;25&#41;&#46; This is particularly relevant during the first 6 months of treatment and in patients who have experienced two or more cardiovascular events prior to initiation of therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On the other hand&#44; the loss of muscle mass derived from any oncological treatment has been shown to be a poor prognostic factor in several tumors such as ovarian<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and prostate&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;15&#44;16</span></a> among others&#46; It also has a negative impact on the quality of life &#40;QoL&#41; of adult cancer patients &#40;mostly global and physical functioning domains&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In view of the possible clinical implications of the effects associated with androgen deprivation in PC&#44; these should be identified and deeply studied at the start of treatment in order to develop preventive strategies &#40;nutritional&#44; training&#44; etc&#46;&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The aim of this prospective study is to quantify the prevalence of osteoporosis&#44; frailty&#44; and sarcopenia in elderly patients with PC before and after treatment with ADT&#46; We present data from an interim analysis of the study evaluating the appearance or worsening of these conditions as a consequence of androgen deprivation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0050" class="elsevierStylePara elsevierViewall">PROSARC is an observational&#44; prospective study carried out in the two hospitals of the Albacete University Hospital Complex&#58; General University Hospital and Nuestra Se&#241;ora del Perpetuo Socorro University Hospital&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Inclusion criteria were patients aged &#8805;70 years&#44; high-risk PC&#44; not candidates for local treatment&#44; and scheduled initiation of ADT &#40;according to clinical practice&#41; after approval of the study&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">During recruitment &#40;started in May 2022 and scheduled to end in May 2025&#41;&#44; urology service specialists will include all those patients eligible for the study who agree to participate&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Data were collected from the visits registered in the medical record &#40;before &#91;baseline situation&#93; and 6 months after the start of deprivation&#41; after inclusion of the first patient and will end one month after the follow-up visit at 6 months of treatment of the last patient included&#46; Variables collected included PC characteristics &#40;stage&#44; prognostic group &#91;International Society of Urological Pathology &#40;ISUP&#41;&#93;&#44; PSA at diagnosis&#41;&#44; and patient characteristics &#40;Charlson comorbidity index&#44; frailty &#91;Fried criteria&#93;&#44; osteoporosis &#91;dual X-ray absorptiometry &#40;DXA&#41;&#93;&#44; sarcopenia &#91;according to European Working Group on Sarcopenia in Older People 2 &#40;EWGSOP2&#41;&#93;&#44; percentage of fat mass&#44; and decreased muscle mass &#91;ratio of appendicular muscle mass &#40;AMM to height<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; as well as additional treatments for metastatic PC&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The GRANMO online calculator was used to calculate the required sample size&#44; selecting the proportions and repeated measures option&#44; and considering the data corresponding to an intermediate analysis with 12 subjects&#44; since there are no data in the literature that allow us to make an initial estimate&#46; Accepting an alpha risk of 0&#46;05 and a beta risk of 0&#46;2 in a bilateral contrast&#44; 42 subjects are required assuming that the initial proportion of events &#40;low muscle mass&#41; is 75&#37; and 99&#37; after 6 months of ADT&#46; A loss-to-follow-up rate of 15&#37; was estimated&#46; This interim analysis did not modify the structure&#44; design&#44; or objectives of the study&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The data were entered&#44; stored&#44; and analyzed using SPSS version 25&#46;0 &#40;Statistical Package for Social Sciences&#44; version 25&#46;0&#46; Armonk&#44; NY&#58; IBM Corp&#46;&#41;&#46; We checked whether the quantitative variables were distributed according to a normal distribution &#40;Kolmogorov&#8211;Smirnov test&#41; and then applied the measures of central tendency and dispersion corresponding to the descriptive study&#44; as well as using the appropriate statistical estimators&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A comparative analysis was performed between subjects before and after treatment &#40;6 months&#41; for each of the variables using mean comparison tests for paired samples &#40;Wilcoxon test&#41; and proportions &#40;McNemar test&#41;&#46; Differences with p less than 0&#46;05 were considered statistically significant&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The study was carried out in accordance with local regulations and was approved by the drug research ethics committee of Albacete&#46; All patients gave their written consent to participate in the study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">Twenty-five patients were included before the data cutoff date &#40;1-May-2023&#41;&#59; 12 with evaluation at 6 months after ADT initiation&#46; The entire selected study-eligible sample agreed to participate&#46; The characteristics of patients and PC are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Prior to ADT&#44; the prevalence of prefrailty&#47;frailty &#40;67&#46;7&#37;&#41;&#44; sarcopenia &#40;66&#46;7&#37;&#41; and osteoporosis &#40;25&#37;&#41; was high &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Subjects with localized disease did not receive local treatment because their life expectancy was less than 10 years&#46; According to clinical criteria&#44; some patients were referred to the Geriatrics department for a comprehensive geriatric assessment in order to identify reversible alterations&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">After 6 months of treatment&#44; there were no statistically significant changes in frailty and sarcopenia&#44; nor variation in osteoporosis or comorbidity&#46; In the 3 subjects in whom osteoporosis was detected&#44; semiannual denosumab was started&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Regarding obesity&#44; there were slight variations in body mass index &#40;BMI&#41;&#44; but without statistical significance&#46; A significant reduction in the mean value of appendicular muscle mass was observed-&#44; variations in patient height during treatment were ruled out&#46; The percentage of patients with decreased muscle mass went from 75&#37; to 100&#37;&#44; without statistical significance &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;250&#41;&#46; The mean value calculated to establish this situation of decreased muscle mass was significantly reduced from 6&#46;1 to 5&#46;6&#46; The increase in the percentage of fat mass was also significant&#44; although slight &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the increase in fat mass &#40;yellow color&#41; and the decrease in muscle mass &#40;red color&#41; after 6 months of ADT&#44; measured by dual X-ray absorptiometry &#40;DXA&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">According to the preliminary data from our study&#44; more than two thirds of elderly patients with high-risk PC are in a pre-frailty&#47;frailty situation&#44; and with sarcopenia&#46; Treatment with ADT &#40;6 months&#41; did not lead to significant changes in frailty&#44; sarcopenia&#44; comorbidity&#44; osteoporosis&#44; or obesity &#40;assessed as changes in BMI&#41;&#46; However&#44; there was a significant loss of muscle mass and a slight increase in fat mass&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The mean age of the PC patients analyzed &#40;84&#46;31 years&#41; was higher than that of the Spanish population of SHARE &#40;Survey of Health&#44; Ageing and Retirement in Europe&#41; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1765&#41;&#46; With a mean age of 75&#46;2 years&#44; it was classified as pre-fragile &#40;73&#37;&#41; and the rest as frail &#40;27&#46;2&#37;&#41;&#44; according to the Fried criteria&#46; If we consider the use of other frailty criteria &#40;multidimensional prognostic index &#91;MPI&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">19</span></a> in a meta-analysis of data from 56&#44;407 subjects of a similar age to the Spanish SHARE sample &#40;mean&#44; 78&#46;6 years&#41;&#44; the proportion of pre-frailty and frailty was 36&#46;4&#37; vs&#46; 26&#46;8&#37;&#44; respectively&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The higher proportion of prefrailty vs&#46; frailty observed in both studies was seen in our patients with PC &#40;50&#37; vs&#46; 16&#46;7&#37;&#41;&#44; even at a higher age &#40;84&#46;31 years&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Additional treatment to ADT in metastatic stage is evaluated in a multidisciplinary tumor board&#46; It was not considered in three cases due to comorbidities of the individuals&#46; In the remaining four&#44; an ARTA was prescribed &#40;two patients with low-risk disease and two with high-risk disease&#41;&#46; None of the two high-risk subjects were candidates for chemotherapy&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The high percentage of osteoporosis &#40;25&#37;&#41; detected in our elderly population reflects the predisposition for osteoporosis and sarcopenia in this age range &#40;&#62;60 years&#41;&#44; owing to the progressive bone mineral density and muscle mass loss&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">20</span></a> However&#44; this is at the lower limit of the figures described in patients diagnosed with PC &#40;25&#37;&#8211;40&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">21</span></a> Nevertheless&#44; we did not observe differences in bone mineral density&#44; despite the fact that ADT causes detectable reductions 6&#8211;9 months after starting treatment &#40;5&#37;&#8211;10&#37; decline in the first year&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">21</span></a> Detection of these reductions may require more time&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">With respect to sarcopenia&#44; there is currently no consensus definition&#44; with different cut off points and clinical criteria&#46; Those proposed by the European Working Group on Sarcopenia in Older People &#40;EWGSOP&#41; and its 2018 updated version &#40;EWGSOP2&#41;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">22</span></a> are the most relevant&#46; These criteria include low muscle mass &#40;a mandatory criterion&#41;&#44; low muscle strength and low physical performance&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">23</span></a> There are very few papers measuring the prevalence of sarcopenia in patients with PC&#44; with variable results ranging between 3&#46;2&#37;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">24</span></a> and 29&#46;2&#37;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">25</span></a> among patients under ADT and 2&#37; in those without hormone blockade&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">25</span></a> In our patients&#44; the prevalence of sarcopenia at baseline was 66&#37;&#46; The large difference in this prevalence could be due to the small sample size&#44; lower mean age &#40;69 years&#41; or by the fact that almost all of them had already been treated for PC&#44; either surgically or with RT&#44; thus patients with advanced disease were not considered&#46; Data on the incidence of sarcopenia in relation to ADT are lacking&#44; and contrary to what might be expected&#44; we observed less sarcopenia after 6 months of treatment&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The baseline status of our patients also reflects the effect of age on muscle mass&#44; with three out of four patients presenting low muscle mass&#46; After 6 months of treatment&#44; all patients presented decreased mass&#44; with significant differences&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Although few articles analyze the impact of current treatments for metastatic PC on the loss of muscle mass&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">26</span></a> it seems logical to think that there is an accelerated decrease in muscle mass as the anti-androgenic effect intensifies with respect to those patients who only receive ADT&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Although this decrease would suggest an increase in sarcopenia&#44; our results show a decrease in sarcopenia&#46; This result could be due to the consideration of muscle strength and function to determine sarcopenia&#44; as well as to the small sample size and measurement period &#40;6 months from the start of treatment&#41;&#46; Therefore&#44; we will not consider changes regarding sarcopenia&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The increased risk of falls&#44; reduced mobility&#44; and loss of QoL as a result of muscle mass loss&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> requires the implementation of measures to reduce the impact of this treatment in patients with PC&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">One of these measures could include exercise training&#44; which has been shown to improve body composition&#44; muscle strength and QoL in this type of patient&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> It has been described that physical exercise&#44; both resistance and aerobic training&#44; can be useful to prevent the negative impact of ADT on bones and muscles&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;27</span></a> Additionally&#44; promoting standardized and supervised training programs of increasing intensity focused on the upper and lower body would be of great benefit for these patients&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Improved body composition through exercise could also benefit the &#40;significant&#41; effect we observed in our patients on the previously described increase in fat mass&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">The care of bones and muscles may benefit from lifestyle changes in these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">27</span></a> Other measures that can be taken to avoid&#47;reduce the impact of ADT on bone health are to ensure an adequate intake of calcium &#40;1000&#8211;1200<span class="elsevierStyleHsp" style=""></span>mg per day&#44; preferably from the diet&#41;&#44; as well as vitamin D &#40;800&#8211;1600<span class="elsevierStyleHsp" style=""></span>IU per day from diet or exposure to sunlight&#41; considering supplements if these sources are not sufficient&#46; The use of bisphosphonates and denosumab can be indicated in case of previous osteoporotic fractures&#44; findings of osteoporosis on DXA or high risk of fracture according to the FRAX&#174; tool&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Therefore&#44; bone health may require calcium and vitamin D supplementation and bisphosphonates or denosumab&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;27&#44;28</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">For the prevention and management of these effects&#44; the participation of a multidisciplinary team including nutritionists&#44; physiotherapists&#44; physical activity&#44; and sport sciences experts&#44; as well as rehabilitation specialists would be necessary to achieve the implementation of various measures&#46; Oncology nurses could assist greatly in the accomplishment and monitoring of these actions&#46; Their role in the education of patients and caregivers as well as in the follow-up of patients&#8217; QoL has been described&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">29</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0190" class="elsevierStylePara elsevierViewall">Androgen deprivation &#40;ADT&#59; 6 months&#41; in patients with high-risk PC&#44; advanced age and a prevalence of osteoporosis&#44; sarcopenia&#44; and considerable frailty&#44; produces a decrease in muscle mass without impacting the incidence of the adverse effects under study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitations</span><p id="par0195" class="elsevierStylePara elsevierViewall">The main limitation of this study is that these are preliminary results with a small sample of subjects &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&#44; justified by the slow recruitment&#46; Therefore&#44; the results obtained should be interpreted with caution&#46; This problem is expected to be solved when the recruitment of the estimated sample required is finalized and all the biannual evaluations are completed&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">The duration of the hormonal treatment in this study&#44; 6 months&#44; should also be considered&#46; Patients usually receive this treatment for longer periods&#44; even lasting several years&#44; with more pronounced long-term alterations being expected&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Despite the limitations and the preliminary nature of the data&#44; they explore a currently unknown area and&#44; and will shed light on the problem within the urological community&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0210" class="elsevierStylePara elsevierViewall">This research has not received specific support from public sector agencies&#44; commercial sector&#44; or non-profit entities&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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            1 => "Androgen deprivation"
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            3 => "Muscle mass"
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          "identificador" => "xpalclavsec1833477"
          "palabras" => array:4 [
            0 => "C&#225;ncer de pr&#243;stata"
            1 => "Privaci&#243;n androg&#233;nica"
            2 => "Fragilidad"
            3 => "Masa muscular"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Prostatic carcinoma &#40;PC&#41; is a frequent neoplasm in elderly patients&#46; Although androgen deprivation is associated with survival benefits&#44; it is also related to adverse effects such as osteoporosis&#44; frailty&#44; or sarcopenia&#44; which can negatively affect the patient&#8217;s quality of life&#46; This study aims to quantify and evaluate the prevalence of osteoporosis&#44; frailty&#44; or sarcopenia in elderly PC patients before and after androgen deprivation&#46; We present data from an interim analysis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">PROSARC is a national &#40;Spain&#41; prospective observational study &#40;May-2022&#8211;May-2025&#41; still in progress in 2 hospitals&#46; It includes patients with high-risk PC&#44; aged &#8805;70 years&#44; non-candidates for local treatment and scheduled to start androgen deprivation therapy&#46; The following variables are analyzed&#58; comorbidity&#44; frailty &#40;Fried frailty phenotype criteria&#41;&#44; osteoporosis&#44; sarcopenia &#40;EWGSOP2&#41;&#44; fat mass and muscle mass&#44; before treatment and after 6 months of follow-up&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A 6-month follow-up was completed by 12&#47;25 included patients &#40;mean age&#44; 84 years&#41;&#44; with a high baseline prevalence of pre-frailty&#47;frailty &#40;67&#46;7&#37;&#41;&#44; sarcopenia &#40;66&#46;7&#37;&#41; and osteoporosis &#40;25&#37;&#41;&#46; Treatment did not significantly alter these variables or comorbidity&#46; We observed changes in body mass index &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;666&#41;&#44; decreased mean value of appendicular muscle mass &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and increased percentage of fat mass &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In patients with high-risk PC&#44; advanced age and a considerable prevalence of osteoporosis&#44; frailty and sarcopenia&#44; androgen deprivation &#40;ADT&#59; 6 months&#41; produces decreased muscle mass without impact on the incidence of the known adverse effects of androgen deprivation&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El carcinoma prost&#225;tico &#40;CP&#41; es una neoplasia frecuente en pacientes de edad avanzada&#46; La privaci&#243;n androg&#233;nica&#44; con beneficio en supervivencia&#44; se relaciona con efectos adversos tales como osteoporosis&#44; fragilidad o sarcopenia&#44; que pueden impactar negativamente en la calidad de vida del paciente&#46; Este estudio pretende cuantificar y evaluar el estado de osteoporosis&#44; fragilidad o sarcopenia en pacientes con CP de edad avanzada antes y despu&#233;s de la privaci&#243;n androg&#233;nica&#46; Presentamos datos de un an&#225;lisis intermedio&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudio nacional &#40;Espa&#241;a&#41; observacional prospectivo&#44; PROSARC&#44; a&#250;n en marcha &#40;mayo del 2022-mayo del 2025&#41; en 2 hospitales&#46; Incluye a pacientes con CP de alto riesgo&#44; &#8805; 70 a&#241;os&#44; no candidatos a tratamiento local e inicio programado de privaci&#243;n androg&#233;nica&#46; Se analizan las siguientes variables&#58; comorbilidad&#44; fragilidad &#40;criterios de Fried&#41;&#44; osteoporosis&#44; sarcopenia &#40;EWGSOP2&#41;&#44; masa grasa y masa muscular&#44; antes del tratamiento y tras 6 meses de seguimiento&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Completaron un seguimiento de 6 meses 12&#47;25 pacientes incluidos &#40;edad media&#44; 84 a&#241;os&#41;&#44; con una elevada prevalencia basal de prefragilidad&#47;fragilidad &#40;67&#44;7&#37;&#41;&#44; sarcopenia &#40;66&#44;7&#37;&#41; y osteoporosis &#40;25&#37;&#41;&#46; El tratamiento no vari&#243; significativamente estas variables ni la comorbilidad&#46; Se observaron cambios en el &#237;ndice de masa corporal &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;666&#41;&#44; reducci&#243;n del valor medio de la masa muscular apendicular &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; e incremento del porcentaje de masa grasa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La privaci&#243;n androg&#233;nica &#40;6 meses&#41; en pacientes con CP de alto riesgo&#44; edad avanzada y una prevalencia considerable de osteoporosis&#44; fragilidad y sarcopenia&#44; produce disminuci&#243;n de masa muscular sin que ello repercuta en la incidencia de los efectos adversos de la privaci&#243;n androg&#233;nica estudiados&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Introducci&#243;n"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Materiales y m&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
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        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "figura" => array:1 [
          0 => array:4 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Dual X-ray absorptiometry &#40;DXA&#41; at baseline and after 6 months of androgen deprivation&#46;</p>"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#59; EWGSOP2&#58; European Working Group on Sarcopenia in Older People 2&#59; GG&#58; prognostic grade group&#59; BMI&#58; body mass index&#59; ISUP&#58; International Society of Urological Pathology&#59; AMM&#58; appendicular muscle mass&#59; PSA&#58; prostate specific antigen&#59; IQR&#58; interquartile range&#59; ADT&#58; androgen deprivation therapy&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6 months&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Age &#40;years&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">84&#44;31 &#40;6&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PSA &#40;ng&#47;ml&#41; at diagnosis&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#44;9 &#40;19&#44;12&#8211;69&#44;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
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                  \t\t\t\t">GG&#95;ISUP&#44; N &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;41&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Stage of disease&#44; N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Localized&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;41&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metastatic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;58&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metastatic disease&#44; N &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Low risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;42&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High grade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;57&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADT additional treatment&#44; N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apalutamide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enzalutamide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;11 &#40;3&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;27 &#40;3&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;666&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Charlson Index&#44; N&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;41&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;41&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;33&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frailty criteria &#40;L&#46; Fried&#41;&#44; N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;091&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;33&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;16&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prefrailty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;58&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frailty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Osteoporosis&#44; N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;222&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">No sarcopenia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Sarcopenia&nbsp;\t\t\t\t\t\t\n
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "S&#46; Wang"
                            3 => "X&#46; Liao"
                            4 => "X&#46; Yi"
                            5 => "K&#46; Jin"
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                    0 => array:2 [
                      "titulo" => "A systematic review evaluating the effectiveness of exercise training on physical condition in prostate cancer patients undergoing androgen deprivation therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Yuan"
                            1 => "Y&#46; Wang"
                            2 => "X&#46; Xiao"
                            3 => "X&#46; Zhang"
                            4 => "M&#46; Jing"
                            5 => "H&#46; Kamecki"
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                  "host" => array:1 [
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                      "doi" => "10.21037/tau-23-272"
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                        "tituloSerie" => "Transl Androl Urol"
                        "fecha" => "2023"
                        "volumen" => "12"
                        "paginaInicial" => "1336"
                        "paginaFinal" => "1350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37680229"
                            "web" => "Medline"
                          ]
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              "etiqueta" => "10"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "A comparison of the sarcopenic effect of androgen receptor-axis-targeted agents vs&#46; androgen deprivation alone in patients with metastatic prostate cancer"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Lawen"
                            1 => "K&#46; Masoumi-Ravandi"
                            2 => "R&#46;A&#46; Rendon"
                            3 => "L&#46; Connor"
                            4 => "R&#46;J&#46; Mason"
                          ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5489/cuaj.8245"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can Urol Assoc J"
                        "fecha" => "2023"
                        "volumen" => "17"
                        "paginaInicial" => "274"
                        "paginaFinal" => "279"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37581552"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
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            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Androgen deprivation in prostate cancer and the long-term risk of fracture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Ojeda"
                            1 => "M&#46; Lloret"
                            2 => "A&#46; Naranjo"
                            3 => "F&#46; D&#233;niz"
                            4 => "N&#46; Chesa"
                            5 => "C&#46; Dom&#237;nguez"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.acuro.2017.01.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Urol Esp"
                        "fecha" => "2017"
                        "volumen" => "41"
                        "paginaInicial" => "491"
                        "paginaFinal" => "496"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28259363"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Androgen deprivation therapy&#44; hypogonadism and cardiovascular toxicity in men with advanced prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;S&#46; Gheorghe"
                            1 => "A&#46;S&#46; Hodorogea"
                            2 => "A&#46; Ciobanu"
                            3 => "I&#46;T&#46; Nanea"
                            4 => "A&#46;C&#46;D&#46; Gheorghe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/curroncol28050289"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Oncol"
                        "fecha" => "2021"
                        "volumen" => "28"
                        "paginaInicial" => "3331"
                        "paginaFinal" => "3346"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34590590"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; O&#8217;Farrell"
                            1 => "H&#46; Garmo"
                            2 => "L&#46; Holmberg"
                            3 => "J&#46; Adolfsson"
                            4 => "P&#46; Stattin"
                            5 => "M&#46; Van Hemelrijck"
                          ]
                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/jco.2014.59.1792"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2015"
                        "volumen" => "33"
                        "paginaInicial" => "1243"
                        "paginaFinal" => "1251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25732167"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            13 => array:3 [
              "identificador" => "bib0070"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muscle loss during primary debulking surgery and chemotherapy predicts poor survival in advanced-stage ovarian cancer"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;Y&#46; Huang"
                            1 => "Y&#46;C&#46; Yang"
                            2 => "T&#46;C&#46; Chen"
                            3 => "J&#46;R&#46; Chen"
                            4 => "Y&#46;J&#46; Chen"
                            5 => "M&#46;H&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jcsm.12524"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cachexia Sarcopenia Muscle"
                        "fecha" => "2020"
                        "volumen" => "11"
                        "paginaInicial" => "534"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31999069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0075"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muscle loss during androgen deprivation therapy is associated with higher risk of non-cancer mortality in high-risk prostate cancer"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;K&#46; Chiang"
                            1 => "W&#46;K&#46; Tsai"
                            2 => "A&#46;W&#46; Chiu"
                            3 => "J&#46;B&#46; Lin"
                            4 => "F&#46;Y&#46; Yang"
                            5 => "J&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fonc.2021.722652"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Oncol"
                        "fecha" => "2021"
                        "volumen" => "11"
                        "paginaInicial" => "722652"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34604058"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0080"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistance exercise counteracts the impact of androgen deprivation therapy on muscle characteristics in cancer patients"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Overkamp"
                            1 => "L&#46;H&#46;P&#46; Houben"
                            2 => "T&#46; Aussieker"
                            3 => "J&#46;M&#46;X&#46; van Kranenburg"
                            4 => "P&#46;J&#46;M&#46; Pinckaers"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/clinem/dgad245"
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                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2023"
                        "volumen" => "108"
                        "paginaInicial" => "e907"
                        "paginaFinal" => "e915"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37161470"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Association between skeletal muscle mass and quality of life in adults with cancer&#58; a systematic review and meta-analysis"
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                          "etal" => false
                          "autores" => array:5 [
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                            2 => "K&#46; Furness"
                            3 => "J&#46; Porter"
                            4 => "C&#46;E&#46; Huggins"
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                        "paginaInicial" => "839"
                        "paginaFinal" => "857"
                        "link" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Prevalence of multidimensional frailty and pre-frailty in older people in different settings&#58; a systematic review and meta-analysis"
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                            1 => "C&#46; Custodero"
                            2 => "A&#46; Cella"
                            3 => "J&#46; Demurtas"
                            4 => "S&#46; Zora"
                            5 => "S&#46; Maggi"
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                        ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arr.2021.101498"
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                        "tituloSerie" => "Ageing Res Rev"
                        "fecha" => "2021"
                        "volumen" => "72"
                        "paginaInicial" => "101498"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34700009"
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                ]
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                    0 => array:2 [
                      "titulo" => "Osteoporosis in older adults"
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                            2 => "E&#46; Legrand"
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Joint Bone Spine"
                        "fecha" => "2021"
                        "volumen" => "88"
                        "paginaInicial" => "105135"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33486108"
                            "web" => "Medline"
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              ]
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              "identificador" => "bib0100"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone loss induced by cancer treatments in breast and prostate cancer patients"
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                        0 => array:2 [
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                            2 => "A&#46; Gonz&#225;lez-Del-Alba"
                            3 => "G&#46; Mart&#237;nez-D&#237;az-Guerra"
                            4 => "X&#46; Nogu&#233;s"
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                    0 => array:2 [
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                        "tituloSerie" => "Clin Transl Oncol"
                        "fecha" => "2022"
                        "volumen" => "24"
                        "paginaInicial" => "2090"
                        "paginaFinal" => "2106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35779210"
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              "identificador" => "bib0105"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcopenia&#58; revised European consensus on definition and diagnosis"
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                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Cruz-Jentoft"
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                            3 => "Y&#46; Boirie"
                            4 => "O&#46; Bruy&#232;re"
                            5 => "T&#46; Cederholm"
                          ]
                        ]
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1093/ageing/afy169"
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                        "tituloSerie" => "Age Ageing"
                        "fecha" => "2019"
                        "volumen" => "48"
                        "paginaInicial" => "16"
                        "paginaFinal" => "31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30312372"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Definici&#243;n y evoluci&#243;n del concepto de sarcopenia"
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                          "etal" => true
                          "autores" => array:6 [
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                            3 => "M&#46; Gonz&#225;lez Casaus"
                            4 => "S&#46; Mas-Fontao"
                            5 => "C&#46; Gracia Iguacel"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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              ]
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              "identificador" => "bib0115"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does use of androgen deprivation therapy &#40;ADT&#41; in men with prostate cancer increase the risk of sarcopenia&#63;"
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                          "etal" => true
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                            1 => "R&#46;M&#46; Daly"
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                            3 => "N&#46;L&#46; Mundell"
                            4 => "P&#46;M&#46; Livingston"
                            5 => "T&#46; Rantalainen"
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                    0 => array:2 [
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                        "tituloSerie" => "Calcif Tissue Int"
                        "fecha" => "2019"
                        "volumen" => "105"
                        "paginaInicial" => "403"
                        "paginaFinal" => "411"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31317232"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0120"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Presence of sarcopenic obesity and evaluation of the associated muscle quality in Japanese older men with prostate cancer undergoing androgen deprivation therapy"
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                            2 => "S&#46; Ohji"
                            3 => "D&#46; Ishiyama"
                            4 => "N&#46; Nishio"
                            5 => "Y&#46; Otobe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jgo.2019.03.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Geriatr Oncol"
                        "fecha" => "2019"
                        "volumen" => "10"
                        "paginaInicial" => "835"
                        "paginaFinal" => "838"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30956136"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Abiraterone plus prednisone in metastatic&#44; castration-sensitive prostate cancer"
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