140 Diabetes mellitus increases the risk of poorly differentiated tumor in prostate cancer patients

Abstract

INTRODUCTION AND OBJECTIVES: The aim of our study was to test the hypothesis that diabetic patients with prostate cancer (PCa) are at a higher risk of harboring more aggressive disease characteristics. METHODS: The study included 104,822 patients diagnosed with PCa between 1992 and 2005 and undergoing different treatment modalities in the Surveillance, Epidemiology and End Results-Medicare linked database. Univariable and multivariable logistic regression analyses were used to test the relationship between diabetes mellitus (DM) status and two endpoints: 1)poorly-differentiated tumors (Gleason score 8-10); 2) locally-advanced PCa (T3-T4 disease). RESULTS: The overall rate of DM was 14%. In diabetic patients, the mean DM duration was 41.6 months (median: 35.0). The rates of DM without complication, DM with complication, and DM with organ failure were 42, 21, and 37%, respectively . After adjusting for all covariates, diabetic men with PCa were 5% more likely to harbor poorly-differentiated disease. Patients with long-term DM ( 35 months) or with DM with organ-failure were 15 and 21% more likely to harbor poorly-differentiated PCa, respectively relative to their nondiabetic counterparts (all p 0.03). Conversely, short-term DM, DM without complication, and DM with complication were not independent predictors of poorly differentiated PCa (odds ratio [OR]: 1.02-1.04, all p 0.2). Likewise, DM was not an independent predictor of a locally advanced disease (OR: 0.94, p 0.1). CONCLUSIONS: Prostate cancer patients with long-term DM, and/or DM with organ failure are at a higher risk of harboring a poorly differentiated tumor. This should be considered, when advising diabetic patients about PCa screening and management.