Metabolic syndrome is associated with advanced prostate cancer in patients treated with radical retropubic prostatectomy: results from a multicentre prospective study

BMC Cancer

Research Article

Riccardo Mastroianni¹  Michele Gallucci¹  Giuseppe Simone²  Devis Collura²  Giovanni Muto²  Cosimo De Nunzio³  Aldo Brassetti³  Andrea Tubaro³ 

[1] Department of Urology, “Regina Elena” National Cancer Institute, Rome, Italy;Department of Urology, “Regina Elena” National Cancer Institute, Rome, Italy;Department of Urology, “San Giovanni Bosco” Hospital, Turin, Italy;Department of Urology, “Sant’Andrea” Hospital, “La Sapienza” University, Rome, Italy;

关键词: Prostate;    Prostate cancer;    Metabolic syndrome;    High grade;   

DOI  :  10.1186/s12885-016-2442-7

 received in 2015-12-18, accepted in 2016-06-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundProstate cancer (PCa) is the most common non-skin cancer in USA and the second leading cause of cancer death in Western Countries. Despite the high mortality associated with PCa, the only established risk factors are age, race and family history. A possible association between metabolic syndrome (MetS) and PCa was firstly described in 2004 and several subsequent studies in biopsy cohorts have shown conflicting results. Aim of our multicentre prospective study was to investigate the association between MetS and PCa in men undergoing radical prostatectomy (RP).MethodsFrom January 2012 to June 2015, 349 consecutive men undergoing RP for PCa at three centres in Italy were enrolled into a prospective database. Body Mass Index (BMI) as well as waist circumference was measured before RP. Blood samples were also collected and tested for total PSA, fasting glucose, triglycerides and HDLs. Blood pressure was also recorded. We evaluated the association between MetS, defined according to Adult Treatment Panel III, PCa stage (advanced stage defined as pT ≥ 3 or N1) and grade (high grade defined as Gleason Score ≥ 4 + 3) using logistic regression analyses.ResultsMedian age and preoperative PSA levels were 66 years (IQR: 61-69) and 7 ng/ml (IQR: 5-10), respectively. Median BMI was 26.12 kg/m2 (IQR 24-29) with 56 (16 %) obese (BMI ≥ 30 kg/m2) patients and 87 (25 %) patients with MetS. At pathological evaluation, advanced PCa and high-grade disease were present in 126 (36 %) and 145 (41.5 %) patients, respectively. MetS was significantly associated with advanced PCa (45/87, 51 % vs 81/262, 31 %; p = 0.008) and high-grade disease (47/87, 54 % vs 98/262, 37 %; p = 0.001). On multivariable analysis, MetS was an independent predictor of pathological stage ≥ pT3a or N1 (OR: 2.227; CI: 1.273-3.893; p = 0.005) and Gleason score ≥ 4 + 3 (OR: 2.007, CI: 1.175-3.428; p = 0.011).ConclusionsWe firstly demonstrated in a European radical retropubic prostatectomy cohort study that MetS is associated with an increased risk of high-grade and advanced prostate cancer. Further studies with long term follow-up should evaluate the impact of Mets on PCa survival.

【 授权许可】

CC BY   
© The Author(s). 2016