Skip to main content

Advertisement

SpringerLink
Log in

Diabetes mellitus is associated with short prostate-specific antigen doubling time after radical prostatectomy

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objective

To investigate whether diabetes mellitus (DM) was associated with postoperative outcomes, including prostate-specific antigen doubling time, among men who underwent radical prostatectomy (RP) for clinically localized prostate cancer (PCa).

Methods

Data of 661 patients who underwent radical prostatectomy for node-negative prostate cancer and were followed up for ≥3 years postoperatively at our institution were analyzed. Associations between diabetes mellitus at surgery and outcomes following radical prostatectomy, such as biochemical recurrence-free survival and prostate-specific antigen doubling time, were examined. Aggressive recurrence was defined as biochemical recurrence with prostate-specific antigen doubling time <9 months.

Results

Of the 661 total subjects, DM (n = 67, 10.1 %) and non-DM group (n = 594, 89.9 %) showed no significant differences in various clinicopathologic parameters including age and PSA. DM group had lower postoperative biochemical recurrence-free survival than non-DM group, with observed difference approaching statistical significance (log-rank, p = 0.077). On multivariate analysis, DM at surgery was significantly associated with aggressive recurrence following RP (p = 0.048). Pathologic Gleason score (p = 0.008) and seminal vesicle invasion (p = 0.010) were also significantly associated with aggressive recurrence on multivariate analysis.

Conclusion

Our results show that pre-existing DM in men with PCa is associated with more aggressive recurrence, suggesting that DM may affect disease progression following RP. Further investigation would be needed to elucidate exact biologic interaction between DM and PCa and also assess causal relationships that potentially could be modified to improve long-term outcome in patients with the two diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bonovas S, Filioussi K, Tsantes A (2004) Diabetes mellitus and risk of prostate cancer: a meta-analysis. Diabetologia 47(6):1071–10782

    Article  PubMed  CAS  Google Scholar 

  2. Kasper JS, Giovannucci E (2006) A meta-analysis of diabetes mellitus and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 15(11):2056–2062

    Article  PubMed  Google Scholar 

  3. Baradaran N, Ahmadi H, Salem S, Lotfi M, Jahani Y, Mehrsai AR, Pourmand G (2009) The protective effect of diabetes mellitus against prostate cancer: role of sex hormones. Prostate 69(16):1744–1750

    Article  PubMed  CAS  Google Scholar 

  4. Kasper JS, Liu Y, Giovannucci E (2009) Diabetes mellitus and risk of prostate cancer in the health professionals follow-up study. Int J Cancer 124(6):1398–1403

    Article  PubMed  CAS  Google Scholar 

  5. Chan JM, Latini DM, Cowan J, Duchane J, Carroll PR (2005) History of diabetes, clinical features of prostate cancer, and prostate cancer recurrence-data from CaPSURE (United States). Cancer Causes Control 16(7):789–797

    Article  PubMed  CAS  Google Scholar 

  6. Gong Z, Neuhouser ML, Goodman PJ, Albanes D, Chi C, Hsing AW, Lippman SM, Platz EA, Pollak MN, Thompson IM, Kristal AR (2006) Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 15(10):1977–1983

    Article  PubMed  Google Scholar 

  7. Leitzmann MF, Ahn J, Albanes D, Hsing AW, Schatzkin A, Chang SC, Huang WY, Weiss JM, Danforth KN, Grubb RL 3rd, Andriole GL (2008) Diabetes mellitus and prostate cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Cancer Causes Control 19(10):1267–1276

    Article  PubMed  Google Scholar 

  8. Patel T, Hruby G, Badani K, Abate-Shen C, McKiernan JM (2010) Clinical outcomes after radical prostatectomy in diabetic patients treated with metformin. Urology 76(5):1240–1244

    Article  PubMed  Google Scholar 

  9. Jayachandran J, Aronson WJ, Terris MK, Presti JC Jr, Amling CL, Kane CJ, Freedland SJ (2010) Diabetes and outcomes after radical prostatectomy: are results affected by obesity and race? Results from the shared equal-access regional cancer hospital database. Cancer Epidemiol Biomarkers Prev 19(1):9–17

    Article  PubMed  Google Scholar 

  10. D’Amico AV, Moul JW, Carroll PR, Sun L, Lubeck D, Chen MH (2003) Surrogate end point for prostate cancer-specific mortality after radical prostatectomy or radiation therapy. J Natl Cancer Inst 95(18):1376–1383

    Article  PubMed  Google Scholar 

  11. Valicenti RK, DeSilvio M, Hanks GE, Porter A, Brereton H, Rosenthal SA, Shipley WU, Sandler HM (2006) Posttreatment prostatic-specific antigen doubling time as a surrogate endpoint for prostate cancer-specific survival: an analysis of Radiation Therapy Oncology Group Protocol 92–02. Int J Radiat Oncol Biol Phys 66(4):1064–1071

    Article  PubMed  Google Scholar 

  12. Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, Partin AW (2005) Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 294(4):433–439

    Article  PubMed  CAS  Google Scholar 

  13. Teeter AE, Banez LL, Presti JC Jr, Aronson WJ, Terris MK, Kane CJ, Amling CL, Freedland SJ (2008) What are the factors associated with short prostate specific antigen doubling time after radical prostatectomy? A report from the SEARCH database group. J Urol 180(5):1980–1984 discussion 1985

    Article  PubMed  Google Scholar 

  14. WHO Expert Consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies Lancet 363(9403):157–163

  15. Abdollah F, Briganti A, Suardi N, Gallina A, Capitanio U, Salonia A, Cestari A, Guazzoni G, Rigatti P, Montorsi F (2011) Does diabetes mellitus increase the risk of high-grade prostate cancer in patients undergoing radical prostatectomy? Prostate Cancer Prostatic Dis 14(1):74–78

    Article  PubMed  CAS  Google Scholar 

  16. Snyder CF, Stein KB, Barone BB, Peairs KS, Yeh HC, Derr RL, Wolff AC, Carducci MA, Brancati FL (2010) Does pre-existing diabetes affect prostate cancer prognosis? A systematic review. Prostate Cancer Prostatic Dis 13(1):58–64

    Article  PubMed  CAS  Google Scholar 

  17. Lee SE, Lee WK, Jeong MS, Abdullajanov M, Kim DS, Park HZ, Jeong SJ, Yoon CY, Byun SS, Choe G, Hong SK (2011) Is body mass index associated with pathological outcomes after radical prostatectomy in Korean men? BJU Int 107(8):1250–1255

    Article  PubMed  Google Scholar 

  18. Kasper JS, Liu Y, Pollak MN, Rifai N, Giovannucci E (2008) Hormonal profile of diabetic men and the potential link to prostate cancer. Cancer Causes Control 19(7):703–710

    Article  PubMed  Google Scholar 

  19. Henderson KD, Goran MI, Kolonel LN, Henderson BE, Le Marchand L (2006) Ethnic disparity in the relationship between obesity and plasma insulin-like growth factors: the multiethnic cohort. Cancer Epidemiol Biomarkers Prev 15(11):2298–2302

    Article  PubMed  CAS  Google Scholar 

  20. Meyerhardt JA, Catalano PJ, Haller DG, Mayer RJ, Macdonald JS, Benson AB 3rd, Fuchs CS (2003) Impact of diabetes mellitus on outcomes in patients with colon cancer. J Clin Oncol 21(3):433–440

    Article  PubMed  Google Scholar 

  21. Verlato G, Zoppini G, Bonora E, Muggeo M (2003) Mortality from site-specific malignancies in type 2 diabetic patients from Verona. Diabetes Care 26(4):1047–1051

    Article  PubMed  Google Scholar 

  22. Saydah SH, Loria CM, Eberhardt MS, Brancati FL (2003) Abnormal glucose tolerance and the risk of cancer death in the United States. Am J Epidemiol 157(12):1092–1100

    Article  PubMed  Google Scholar 

  23. Coughlin SS, Calle EE, Teras LR, Petrelli J, Thun MJ (2004) Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol 159(12):1160–1167

    Article  PubMed  Google Scholar 

  24. Peairs KS, Barone BB, Snyder CF, Yeh HC, Stein KB, Derr RL, Brancati FL, Wolff AC (2011) Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol 29(1):40–46

    Article  PubMed  Google Scholar 

  25. Hong SK, Oh JJ, Byun SS, Hwang SI, Lee HJ, Choe G, Lee SE (2012) Impact of diabetes mellitus on the detection of prostate cancer via contemporary multi (≥ = 12)-core prostate biopsy. Prostate 72(1):51–57

    Article  PubMed  Google Scholar 

  26. Hong SK, Lee ST, Kim SS, Min KE, Byun SS, Cho SY, Choe G, Lee SE (2009) Significance of preoperative HbA1c level in patients with diabetes mellitus and clinically localized prostate cancer. Prostate 69(8):820–826

    Article  PubMed  CAS  Google Scholar 

  27. Kim HS, Presti JC Jr, Aronson WJ, Terris MK, Kane CJ, Amling CL, Freedland SJ (2010) Glycemic control and prostate cancer progression: results from the SEARCH database. Prostate 70(14):1540–1546

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

All authors have no conflict of interest with any institution or product.

Author information

Authors and Affiliations

  1. Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

    Jong Jin Oh

  2. Department of Urology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam, Kyunggi-do, 463-707, Korea

    Sung Kyu Hong, Sangchul Lee, Seung June Sohn & Sang Eun Lee

Authors
  1. Jong Jin Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sung Kyu Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sangchul Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seung June Sohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sang Eun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sung Kyu Hong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oh, J.J., Hong, S.K., Lee, S. et al. Diabetes mellitus is associated with short prostate-specific antigen doubling time after radical prostatectomy. Int Urol Nephrol 45, 121–127 (2013). https://doi.org/10.1007/s11255-012-0306-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-012-0306-x

Keywords

Search

Navigation