Jerry Polesel1, Andrea Gini2, Luigino Dal Maso3, Carmen Stocco4, Silvia Birri5, Martina Taborelli6, Diego Serraino7, Antonella Zucchetto8. 1. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: polesel@cro.it. 2. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: agini@cro.it. 3. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: dalmaso@cro.it. 4. Venetian Cancer Registry, Istituto Oncologico Veneto, Passaggio Gaudenzio 1, 35131 Padua (PD), Italy. Electronic address: carmen.stocco@ioveneto.it. 5. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: birris@cro.it. 6. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: mtaborelli@cro.it. 7. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: serrainod@cro.it. 8. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, via Franco Gallini 2, 33081 Aviano (PN), Italy. Electronic address: zucchetto.epi@cro.it.
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.
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.