BACKGROUND: Obesity is consistently linked with prostate cancer (PCa) recurrence and mortality, though the mechanism is unknown. Impaired glucose regulation, which is common among obese individuals, has been hypothesized as a potential mechanism for PCa tumor growth. In this study, we explore the relationship between serum glucose at time of treatment and risk of PCa recurrence following initial therapy. METHODS: The study group comprised 1734 men treated with radical prostatectomy (RP) or radiation therapy (RT) for localized PCa between 2001-2010. Serum glucose levels closest to date of diagnosis were determined. PCa recurrence was determined based on PSA progression (nadir PSA+2 for RT; PSA≥0.2 for RP) or secondary therapy. Multivariate Cox regression was performed to determine whether glucose level was associated with biochemical recurrence after adjusting for age, race, body mass index, comorbidity, diagnosis of diabetes, Gleason Sum, PSA, treatment and treatment year. RESULTS: Recurrence was identified in 16% of men over a mean follow-up period of 41 months (range 1-121 months). Those with elevated glucose (≥100 mg/dl) had a 50% increased risk of recurrence (HR 1.5, 95% CI: 1.1-2.0) compared with those with a normal glucose level (<100 mg/dl). This effect was seen in both those undergoing RP (HR 1.9, 95% CI: 1.0-3.6) and those treated with RT (HR 1.4, 95% CI: 1.0-2.0). CONCLUSIONS: Glucose levels at the time of PCa diagnosis are an independent predictor of PCa recurrence for men undergoing treatment for localized disease.
BACKGROUND:Obesity is consistently linked with prostate cancer (PCa) recurrence and mortality, though the mechanism is unknown. Impaired glucose regulation, which is common among obese individuals, has been hypothesized as a potential mechanism for PCa tumor growth. In this study, we explore the relationship between serum glucose at time of treatment and risk of PCa recurrence following initial therapy. METHODS: The study group comprised 1734 men treated with radical prostatectomy (RP) or radiation therapy (RT) for localized PCa between 2001-2010. Serum glucose levels closest to date of diagnosis were determined. PCa recurrence was determined based on PSA progression (nadir PSA+2 for RT; PSA≥0.2 for RP) or secondary therapy. Multivariate Cox regression was performed to determine whether glucose level was associated with biochemical recurrence after adjusting for age, race, body mass index, comorbidity, diagnosis of diabetes, Gleason Sum, PSA, treatment and treatment year. RESULTS: Recurrence was identified in 16% of men over a mean follow-up period of 41 months (range 1-121 months). Those with elevated glucose (≥100 mg/dl) had a 50% increased risk of recurrence (HR 1.5, 95% CI: 1.1-2.0) compared with those with a normal glucose level (<100 mg/dl). This effect was seen in both those undergoing RP (HR 1.9, 95% CI: 1.0-3.6) and those treated with RT (HR 1.4, 95% CI: 1.0-2.0). CONCLUSIONS:Glucose levels at the time of PCa diagnosis are an independent predictor of PCa recurrence for men undergoing treatment for localized disease.
Authors: Howard S Kim; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Prostate Date: 2010-10-01 Impact factor: 4.104
Authors: Steven B Zeliadt; Richard M Hoffman; Ruth Etzioni; Van Anh T Ginger; Daniel W Lin Journal: J Gen Intern Med Date: 2010-08-10 Impact factor: 5.128
Authors: Jayakrishnan Jayachandran; William J Aronson; Martha K Terris; Joseph C Presti; Christopher L Amling; Christopher J Kane; Stephen J Freedland Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-01 Impact factor: 4.254
Authors: Jing Ma; Haojie Li; Ed Giovannucci; Lorelei Mucci; Weiliang Qiu; Paul L Nguyen; J Michael Gaziano; Michael Pollak; Meir J Stampfer Journal: Lancet Oncol Date: 2008-10-03 Impact factor: 41.316
Authors: Carrie N Klabunde; Julie M Legler; Joan L Warren; Laura-Mae Baldwin; Deborah Schrag Journal: Ann Epidemiol Date: 2007-05-25 Impact factor: 3.797
Authors: Andrew Flood; Volker Mai; Ruth Pfeiffer; Lisa Kahle; Alan T Remaley; Elaine Lanza; Arthur Schatzkin Journal: Gastroenterology Date: 2007-08-21 Impact factor: 22.682
Authors: Matthew R Smith; Kyounghwa Bae; Jason A Efstathiou; Gerald E Hanks; Miljenko V Pilepich; Howard M Sandler; William U Shipley Journal: J Clin Oncol Date: 2008-09-10 Impact factor: 44.544
Authors: Saira Khan; Jianwen Cai; Matthew E Nielsen; Melissa A Troester; James L Mohler; Elizabeth T H Fontham; Laura H Hendrix; Laura Farnan; Andrew F Olshan; Jeannette T Bensen Journal: Prostate Date: 2017-03-06 Impact factor: 4.104
Authors: L C Macleod; L J Chery; E Y C Hu; S B Zeliadt; S K Holt; D W Lin; M P Porter; J L Gore; J L Wright Journal: Prostate Cancer Prostatic Dis Date: 2015-03-31 Impact factor: 5.554
Authors: Andréia Vasconcelos-Dos-Santos; Rafaela Muniz de Queiroz; Bruno da Costa Rodrigues; Adriane R Todeschini; Wagner B Dias Journal: J Bioenerg Biomembr Date: 2018-01-11 Impact factor: 2.945
Authors: Brian Winters; Stephen Plymate; Steven B Zeliadt; Sarah Holt; Xiaotun Zhang; Elaine Hu; Daniel W Lin; Colm Morrissey; Bryan Wooldridge; John L Gore; Michael P Porter; Jonathan L Wright Journal: Prostate Date: 2015-07-22 Impact factor: 4.104
Authors: Jeannette M Schenk; Marian L Neuhouser; Sarah J Beatty; Matthew VanDoren; Daniel W Lin; Michael Porter; John L Gore; Roman Gulati; Stephen R Plymate; Jonathan L Wright Journal: Contemp Clin Trials Date: 2019-04-16 Impact factor: 2.226
Authors: Kyeezu Kim; Angela Kong; Robert C Flanigan; Marcus L Quek; Courtney M P Hollowell; Patricia P Vidal; Jefferey Branch; Leslie A Dean; Virgilia Macias; Andre A Kajadacsy-Balla; Marian L Fitzgibbon; Daisy Cintron; Li Liu; Vincent L Freeman Journal: Cancer Causes Control Date: 2019-02-07 Impact factor: 2.506