AUA 2017: The Association of BMI and DM with Survival among Patients with Metastatic or Castration-Resistant Prostate Cancer

Boston, MA ( Prostate cancer progression and mortality are significantly higher in men with metastatic (mPCa) and/or castration-resistant prostate cancer (CRPC). Because of the uncharacteristic natural history of these high-risk diagnoses, patients diagnosed with mPCa or CRPC are often censored from analysis in randomized control trials and prospective studies. To address patient-related factors that may impact prostate cancer mortality, Dr. Svetlana Avulova from Vanderbilt University Medical Center reports on 79 patients with mPCa and CRPC in a dedicated outpatient clinic at Vanderbilt Comprehensive Prostate Cancer Clinic.

The greatest benefit of the present study design was the inclusion of comorbidities as extracted from electronic medical records under approved IRB. Data pertaining to overall health, body mass index (BMI) and diabetes mellitus at the time of PC diagnosis were used to estimate overall survival (OS) with the Kaplan Meier method.

As to be expected in this particularly high-risk group of PC patients with mPCa and CRPC, over 49.3% of patients had a Gleason 8 or greater on biopsy with a median PSA of 14.91 ng/mL. Over 25.3% of patients presented with metastatic disease at the time of diagnosis, while 2.7% of patients had pre-existing DM. Median BMI were 28.5 kg/m2. In multivariate analysis adjusted for baseline clinic-pathological factors, DM was associated with worse 5-year mortality (22.9% vs. 9.3%, p=0.042). While there was a trend associated with obesity (BMI > 30 kg/m2) in lower 5-year mortality (6.1% vs. 13.9%, p=0.052), multivariate analysis showed independent association with overall survival after adjusting for age, DM, stage, PSA, and Gleason score at diagnosis.

Overall survival for men diagnosed with prostate cancer was shown to be associated with increased BMI and DM. While this association was adjusted for clinical characteristics at the time of diagnosis, future study analysis would benefit with inclusion of pathological characteristics post-primary treatment.

Presented By: Svetlana Avulova (MD) from Vanderbilt University Medical Center

Authors: Zachary A Glaser*, Svetlana Avulova, Blair Stocks, David F Penson, Kelvin A Moses, Nashville, TN

Written By: Linda Huynh (BS), an assistant research specialist from the University of California, Irvine, on behalf of

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA