We evaluated the influence of comorbidity inferred risks for lymph node metastasis (pN1) and positive surgical margins (R1) after radical prostatectomy in order to optimize pretherapeutic risk classification. We analyzed 454 patients after radical prostatectomy (RP) between 2009 and 2014. Comorbidities were defined by patients' medication from our electronic patient chart and stratified according to the ATC WHO code. Endpoints were lymph node metastasis (pN1) and positive surgical margins (R1).
Rates for pN1 and R1 were 21.4% (97/454) and 29.3% (133/454), respectively. In addition to CAPRA and Gleason score, we identified diabetes as a significant medication inferred risk factor for pN1 (OR 2.9, p = 0.004/OR 3.2, p = 0.001/OR 3.5, p = 0.001) and beta-blockers for R1 (OR 1.9, p = 0.020/OR 2.9, p = 0.004). Patients with diabetes showed no statistically significant difference in Gleason score, CAPRA Score, PSA, and age compared to non-diabetic patients.
We identified diabetes and beta1 adrenergic blockage as significant risk factors for lymph node metastasis and positive surgical margins in prostate cancer (PCa). Patients at risk will need intensive pretherapeutic staging for optimal therapeutic stratification.
World journal of surgical oncology. 2017 Feb 21*** epublish ***
Malte Krönig, Christian Haverkamp, Antonia Schulte, Laura Heinicke, Kathrin Schaal, Vanessa Drendel, Martin Werner, Ulrich Wetterauer, Wolfgang Schultze-Seemann, Cordula Annette Jilg
Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. ., IT-Department, Uniklinikum Freiburg, Agnesenstrasse 6-8, 79106, Freiburg, Germany., Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany., Institut of Clinical Pathology, Uniklinikum Freiburg, Breisacher Strasse 115a, 79106, Freiburg, Germany.