MP32-18 METABOLIC SYNDROME AND LONG-TERM PROSTATE CANCER OUTCOMES AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP32)1 Sep 2021MP32-18 METABOLIC SYNDROME AND LONG-TERM PROSTATE CANCER OUTCOMES AFTER RADICAL PROSTATECTOMY Jennifer E. Wong, Tyler R. Erickson, Lauren E. Howard, Amanda M. De Hoedt, Christopher J. Kane, Martha K. Terris, Matthew R. Cooperberg, Christopher L. Amling, Zachary Klaassen, William J. Aronson, Stephen J. Freedland, and Adriana C. Vidal Jennifer E. WongJennifer E. Wong More articles by this author , Tyler R. EricksonTyler R. Erickson More articles by this author , Lauren E. HowardLauren E. Howard More articles by this author , Amanda M. De HoedtAmanda M. De Hoedt More articles by this author , Christopher J. KaneChristopher J. Kane More articles by this author , Martha K. TerrisMartha K. Terris More articles by this author , Matthew R. CooperbergMatthew R. Cooperberg More articles by this author , Christopher L. AmlingChristopher L. Amling More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , William J. AronsonWilliam J. Aronson More articles by this author , Stephen J. FreedlandStephen J. Freedland More articles by this author , and Adriana C. VidalAdriana C. Vidal More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002036.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Metabolic syndrome (MetS) has been shown to increase prostate cancer (PC) risk, but association between MetS and PC outcomes after radical prostatectomy (RP) is poorly established. We aimed to analyze associations between MetS and biochemical recurrence (BCR), metastasis, castration-resistant PC (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) after RP. METHODS: Men who underwent RP at 8 Veterans Affairs Medical Centers between 2000-2017 were analyzed in the SEARCH database. MetS was defined as having 3 of 5 components: hypertension (systolic blood pressure (BP) >130mmHg or diastolic BP >85mmHg), obesity (body mass index >30 kg/m2), high triglycerides (≥150mg/dL), low high-density lipoprotein (<40mg/dL), and diabetes (ICD-9 or ICD-10 code). Baseline patient characteristics stratified by MetS were compared using Wilcoxon rank sum tests for continuous variables and Chi-squared tests for categorical variables. Association between MetS and time to BCR, metastasis, CRPC, ACM, and PCSM was analyzed using Cox proportional hazards models adjusted for demographics (age, race, pre-operative PSA, year of surgery, and surgical center), clinical characteristics (biopsy grade group and clinical stage), and pathological characteristics (pathological grade group, margin status, extracapsular extension, seminal vesicle invasion, and lymph node status). RESULTS: Of 4587 men, 1605 (35%) had MetS at time of RP. During follow-up, 30% of 4587 men developed BCR, 3.6% developed metastasis, 2.4% developed CRPC, 16% died, and 1.7% died due to PC. In adjusted models, there was no association between MetS and BCR risk (HR=1.02; 95%CI: 0.91-1.14), metastasis risk (HR=1.23; 95%CI: 0.90-1.68), or ACM (HR=1.11; 95%CI: 0.96-1.30), all p ≥0.056. However, MetS was associated with increased CRPC and PCSM risk on univariable analysis (HR=1.57; 95%CI: 1.08-2.29, p=0.019, HR=2.02; 95%CI: 1.29-3.16, p=0.002 respectively), analysis adjusted for demographic and clinical characteristics (HR=1.68; 95%CI: 1.15-2.46, p=0.008, HR=2.21; 95%CI: 1.41-3.49, p=0.001 respectively), and analysis adjusted for demographic and pathological characteristics (HR=1.57; 95%CI: 1.07-2.31, p=0.022; HR=1.94; 95%CI: 1.22-3.08, p=0.005 respectively). CONCLUSIONS: Our findings suggest that following RP, MetS increases risk for CRPC and PCSM but not BCR, metastasis, and ACM. If confirmed, managing MetS components may reduce CRPC and PCSM risk in PC patients. Source of Funding: Support for this study was provided by American Cancer Society Research Scholar Grant RSG-18-018-01-CPHPS to ACV. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e573-e574 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer E. Wong More articles by this author Tyler R. Erickson More articles by this author Lauren E. Howard More articles by this author Amanda M. De Hoedt More articles by this author Christopher J. Kane More articles by this author Martha K. Terris More articles by this author Matthew R. Cooperberg More articles by this author Christopher L. Amling More articles by this author Zachary Klaassen More articles by this author William J. Aronson More articles by this author Stephen J. Freedland More articles by this author Adriana C. Vidal More articles by this author Expand All Advertisement Loading ...