249 THE RELATIONSHIP BETWEEN METABOLIC SYNDROME AND PROSTATE CANCER (2010)

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2010249 THE RELATIONSHIP BETWEEN METABOLIC SYNDROME AND PROSTATE CANCER Jesse Sammon, Mireya Diaz-Insua, Emil Kheterpal, Sanjeev Kaul, Piyush K. Agarwal, Ali Dabaja, and Mani Menon Jesse SammonJesse Sammon More articles by this author , Mireya Diaz-InsuaMireya Diaz-Insua More articles by this author , Emil KheterpalEmil Kheterpal More articles by this author , Sanjeev KaulSanjeev Kaul More articles by this author , Piyush K. AgarwalPiyush K. Agarwal More articles by this author , Ali DabajaAli Dabaja More articles by this author , and Mani MenonMani Menon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.308AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prevalence of metabolic syndrome (MS) has been increasing worldwide, however its association with prostate cancer (CaP) is not well established. Components of MS have been correlated with hyperinsulinemia and low circulating testosterone which may confer an increased risk of aggressive prostate cancer. We retrospectively reviewed patients undergoing robotic radical prostatectomy (RRP) to evaluate if those with MS had more aggressive disease characteristics. METHODS A prospectively maintained database of all patients undergoing RRP between January 2001 and December 2008 was queried for components of MS (BMI ≥30 and 2 or more of the following: hypertension, diabetes or elevated blood glucose and dyslipidemia; n=202). Patients with no components of MS were used as controls (n =1,364). Biopsy and final pathology were compared between the two groups in three conditions: (1) using all controls, (2) using multiple matched controls based on greedy matching by propensity score, and (3) using the best controls from the greedy matching. The propensity score was built using logistic regression to estimate the probability of being an individual with MS given age, race, family history, clinical stage, pre-operative PSA and year of surgery. Continuous variables were assessed with the T-test; categorical values with Fischer's exact, Chi-square, or the Mantel-Haenszel tests. A p-value <0.05 was deemed statistically significant. RESULTS All confounding variables were balanced between groups in the Best controls; Un-matched controls were confounded by race and age; Multiple Matched controls by race. Table 1 demonstrates significant differences between those with MS and without it, in the cohort of Unmatched controls and Multiple Matched controls, in terms of Gleason score and pathologic stage. However, in the set of Best Matched controls, the only difference observed was in pathologic grade, with lower Gleason score in the controls. There was no statistically significant difference in biochemical recurrence. CONCLUSIONS Compared to un-matched controls, patients with the MS were found to have higher biopsy and pathology Gleason scores, and greater incidence of advanced stage disease. When controlling for confounders, those with MS were found to have more significant disease. Detroit, MI© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e98 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jesse Sammon More articles by this author Mireya Diaz-Insua More articles by this author Emil Kheterpal More articles by this author Sanjeev Kaul More articles by this author Piyush K. Agarwal More articles by this author Ali Dabaja More articles by this author Mani Menon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...