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

Prostatic 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. PROSARC 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. A 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). In 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. El 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. Estudio 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), osteo