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

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 11.6 years, 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: 1.03-236), which increased to 1.76 (95% CI: 0.99-3.13) when at least two out of three metabolic disorders (i.e., waist circumference >= 102 cm, 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: 138-3.54) for DM, 1.45 (95% CI: 0.97-2.19) for waist circumference >= 102 cm, 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. (C) 2016 Elsevier Inc. All rights reserved.