PD62-05 ASSOCIATION OF DIET AND NUTRIENT INTAKE WITH BIOPSY UPGRADING IN MEN WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD62)1 Apr 2020PD62-05 ASSOCIATION OF DIET AND NUTRIENT INTAKE WITH BIOPSY UPGRADING IN MEN WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE Zhuo T. Su*, Mufaddal K. Mamawala, Patricia K. Landis, Morgan Kuczler, Michael A. Gorin, Christian P. Pavlovich, and Bruce J. Trock Zhuo T. Su*Zhuo T. Su* More articles by this author , Mufaddal K. MamawalaMufaddal K. Mamawala More articles by this author , Patricia K. LandisPatricia K. Landis More articles by this author , Morgan KuczlerMorgan Kuczler More articles by this author , Michael A. GorinMichael A. Gorin More articles by this author , Christian P. PavlovichChristian P. Pavlovich More articles by this author , and Bruce J. TrockBruce J. Trock More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000979.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is increasingly offered to men with low-risk prostate cancer. However, there are limited data to determine if diet, nutrients, and/or supplements can affect the risk of biopsy upgrading. Therefore, we evaluated diet, nutrient and supplement intakes for their association with biopsy upgrading in men on AS. METHODS: We used data from a prospective cohort of men with very-low-risk and low-risk prostate cancer managed with AS at Johns Hopkins since 1995. Patients completed the Block Food Frequency Questionnaire at baseline, from which daily intakes of foods and nutrients from both foods and supplements were calculated. We evaluated biopsy upgrading (Grade Group ≥2 on a surveillance biopsy) via a cumulative-incidence, competing-risks approach; competing events included volume reclassification on biopsy (increase to positive cores >2 or maximum core involvement >50%), elective treatment in the absence of upgrading or volume reclassification, and death due to causes other than prostate cancer. We used univariable and multivariable competing-risks regression to assess diet and nutrient factors as predictors of biopsy upgrading. Multivariable models assessed daily nutrient intakes adjusted for caloric intake via the regression approach, additionally adjusting for year of diagnosis, patient age, prostate-specific antigen density, positive biopsy cores and body mass index at diagnosis, and adding absolute total caloric intake as a covariate as recommended (Willett, Stampfer. Am J Epidemiol 1986). RESULTS: This study included 1,227 patients; 311 (25%) had biopsy upgrading. Median follow-up was 6 years. Cumulative incidence of upgrading was 22% at 5 years and 37% at 10 years. Fourteen diet and nutrient variables had p<.20 in univariable regression and were selected for multivariable regression. Using a false discovery rate (FDR) adjusted p<.004 for 14 comparisons of the top vs. bottom quintile of nutrient intakes, total fat intake (subdistribution hazard ratio (SHR) 0.27, p=.003; top quintile ≥10.2 g daily, bottom quintile ≤4.7 g) and total trans fatty acid intake (SHR 0.41, p=.003; top quintile ≥7.2 g daily, bottom quintile ≤2.6 g) were associated with lower risks of upgrading. When nutrient intakes were assessed as continuous variables, total trans fatty acids, gamma tocopherol, and selenium from foods and supplements combined were associated with lower risks of upgrading (p<.05), albeit not significant under FDR adjusted p<.004. CONCLUSIONS: In a large cohort of men with prostate cancer on AS, higher intakes of total fat and trans fatty acids reported at baseline were associated with lower risks of biopsy upgrading controlling for FDR. These findings are unexpected and additional confirmatory research is needed. Source of Funding: ZTS was supported by a Persky Research Award from the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1287-e1287 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zhuo T. Su* More articles by this author Mufaddal K. Mamawala More articles by this author Patricia K. Landis More articles by this author Morgan Kuczler More articles by this author Michael A. Gorin More articles by this author Christian P. Pavlovich More articles by this author Bruce J. Trock More articles by this author Expand All Advertisement PDF downloadLoading ...