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[23] These eight studies involved local therapy with RT in five trials, RP in one trial[12] and no local therapy in two trials. Of note, the meta-analysis found no significant increase in the risk of cardiovascular death with the use of AHT (RR 0.93, P?=?0.41). In fact, treatment with AHT was associated with a lower cancer-specific (RR 0.69, P? http://www.selleckchem.com/products/midostaurin-pkc412.html study population was younger (median age 65 years) than that reported in several prior series.[17, 20, 21, 28] This is an important consideration, for as shown in our data, as well as the study by Nanda et?al., age is associated with all-cause mortality.[20] Furthermore, the patients in the present study were deemed to be surgical candidates. Thus, although they had the noted comorbidity profile, these conditions might have been less severe compared with patients from RT studies. In fact, RP patients https://en.wikipedia.org/wiki/Ketanserin have been noted to be younger and with fewer comorbidities than RT patients.[24, 25] Nevertheless, the comorbidity measure http://www.selleckchem.com/products/liproxstatin-1.html of CCI has previously been found, as noted here, to stratify patients' risk of non-prostate cancer death after RP.[30] Additionally, the present study was based on preoperative clinical staging rather than pathological staging; this might be useful both in preoperative counseling, but also for consideration when using androgen deprivation with concomitant radiation therapy. We recognize that the present study was limited by its retrospective, non-randomized design. In addition, the number of patients with significant comorbidities was relatively small, with 142 patients (11%) having a CCI ��2. We also recognize the arbitrary nature of our definition of CVD, and acknowledge that in such a cohort of surgically treated patients, the presence of CVD as assigned here was not found to be associated with non-cancer death, likely reflecting the overall health of patients selected for surgery. Furthermore, the evaluation of CCI and CVD does not include possible risk factors for cardiovascular disease, such as hyperlipidemia, tobacco use or family history, which might contribute to a patient's cardiovascular risk profile. In addition, AHT usage among the patients here was not uniform in terms of either the agent or duration of therapy.