The impact of diabetes and other metabolic disorders on prostate cancer prognosis

J Diabetes Complications. 2016 May-Jun;30(4):591-6. doi: 10.1016/j.jdiacomp.2016.02.008. Epub 2016 Feb 9.

Abstract

Aims: To investigate the impact of diabetes mellitus (DM) and other metabolic disorders on the survival of men with prostate cancer (PCa).

Methods: We conducted a retrospective cohort-study based on 715 men with PCa, originally enrolled in an Italian case-control study between 1995 and 2002. Anthropometric measures, self-reported medical conditions, and Gleason score were assessed at enrollment. Adjusted hazard ratios (HRs) of death, with 95% confidence intervals (95% CIs), were estimated using Fine and Gray's regression model.

Results: After a median follow-up of 11.6years, 244 (34.1%) deaths occurred, 77 (31.6%) due to PCa. Excess mortality from all causes was reported in PCa patients with DM (HR=1.56, 95% CI: 1.03-2.36), which increased to 1.76 (95% CI: 0.99-3.13) when at least two out of three metabolic disorders (i.e., waist circumference ≥102cm, drug-treated hypertension, and hypercholesterolemia) were additionally present. The impact of metabolic disorders was stronger on non-PCa-specific mortality with HRs equal to 2.21 (95% CI: 1.38-3.54) for DM, 1.45 (95% CI: 0.97-2.19) for waist circumference ≥102cm, and 1.63 (95% CI: 1.19-2.22) for drug-treated hypertension.

Conclusions: DM and other metabolic disorders unfavorably affected the survival of PCa patients, mainly impacting on the risk of death from causes other than PCa.

Keywords: Diabetes mellitus; Metabolic disorders; Obesity; Prostate cancer; Survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Case-Control Studies
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Follow-Up Studies
  • Humans
  • Hypercholesterolemia / complications*
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Italy / epidemiology
  • Male
  • Metabolic Syndrome / complications*
  • Middle Aged
  • Mortality
  • Neoplasm Grading
  • Obesity, Abdominal / complications*
  • Prognosis
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology
  • Retrospective Studies
  • Self Report
  • Survival Analysis
  • Waist Circumference

Substances

  • Antihypertensive Agents