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-1) 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-1). 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.
Written by:
Wright JL, Plymate SR, Porter MP, Gore JL, Lin DW, Hu E, Zeliadt SB. Are you the author?
Department of Urology, University of Washington School of Medicine, Seattle, WA, USA; Urology Section, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Reference: Prostate Cancer Prostatic Dis. 2013 Mar 5. Epub ahead of print.
doi: 10.1038/pcan.2013.5
PubMed Abstract
PMID: 23459096
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