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Inicio Actas Urológicas Españolas (English Edition) The association between metabolic syndrome and prostate cancer: Effect on cancer...
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Vol. 39. Issue 3.
Pages 154-160 (April 2015)
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Vol. 39. Issue 3.
Pages 154-160 (April 2015)
Original article
The association between metabolic syndrome and prostate cancer: Effect on cancer aggressiveness and progression
Asociación entre síndrome metabólico y cáncer de próstata: efecto sobre su agresividad y progresión
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A. Sanchís-Bonet
Corresponding author
asanchisbonet@yahoo.es

Corresponding author.
, F. Ortiz-Vico, N. Morales-Palacios, M. Sánchez-Chapado
Servicio de Urología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Tables (5)
Table 1. Characteristics of patients in the cohort in terms of present or absent PC diagnosis.
Table 2. Pathological and clinical characteristics of patients according to the presence or absence of MS in patients diagnosed with PC and undergoing RP.
Table 3. Predictive study of the Gleason score of the specimen (≥7 versus <7).
Table 4. Predictive study of staging of the specimen.
Table 5. Prognostic study of biochemical recurrence.
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Abstract
Objectives

To evaluate the impact of metabolic syndrome and its individual components on prostate biopsy findings, the radical prostatectomy specimen and on biochemical recurrence.

Materials and methods

An observational study was conducted of 1319 men who underwent prostate biopsy between January 2007 and December 2011. The impact on the biopsy findings, the radical prostatectomy specimen and biochemical recurrence was evaluated using logistic regression and Cox regression.

Results

Of the 1319 patients, 275 (21%) had metabolic syndrome, and 517 prostate cancers were diagnosed. A greater percentage of metabolic syndrome was found among patients with prostate cancer than among patients without prostate cancer (25% versus 18%; p=.002). Poorer results were found in the radical prostatectomy specimens (Gleason score7, p<.001; stageT2c, p<.001; positive surgical margins, p<.001), and there was a greater percentage of biochemical recurrence in patients with metabolic syndrome than in those without metabolic syndrome (24% versus 13%; p=.003). Metabolic syndrome behaved as an independent predictive factor of finding a Gleason score7 for the specimen, as well as for finding a specimen stageT2c. Metabolic syndrome was also able to independently predict a greater rate of biochemical recurrence (OR: 3.6, p<.001; OR: 3.2, p=.03; HR: 1.7; respectively).

Conclusions

Metabolic syndrome is associated with poorer findings in the radical prostatectomy specimens and is an independent prognostic factor of biochemical recurrence.

Keywords:
Prostate cancer
Metabolic syndrome
Gleason score
Biochemical recurrence
Resumen
Objetivos

Evaluar el impacto del síndrome metabólico y de sus componentes individuales en los hallazgos en la biopsia de próstata, la pieza de prostatectomía radical y en la recidiva bioquímica.

Material y métodos

Estudio observacional de 1.319 varones sometidos a biopsia de próstata entre enero de 2007 y diciembre de 2011. El impacto en los hallazgos en la biopsia, en la pieza de prostatectomía radical y en la recidiva bioquímica se ha evaluado mediante regresión logística y regresión de Cox.

Resultados

De los 1.319 pacientes 275 (21%) presentaban Síndrome metabólico y se diagnosticaron 517 cánceres de próstata. Se encontró un mayor porcentaje de síndrome metabólico entre pacientes con cáncer de próstata que entre pacientes sin cáncer de próstata (25% frente a 18%; p=0,002). Se encontraron peores hallazgos en la pieza de prostatectomía radical (grado de Gleason7, p<0,001; estadioT2c, p<0,001; márgenes quirúrgicos positivos, p<0,001) y un mayor porcentaje de recidivas bioquímicas en pacientes con síndrome metabólico que sin síndrome metabólico (24% frente a 13%; p=0,003). El síndrome metabólico se comportó como factor predictivo independiente de encontrar un grado de Gleason de la pieza7, así como de encontrar un estadio de la piezaT2c, y fue capaz de predecir de forma independiente una mayor tasa de recidivas bioquímicas (p<0,001, OR: 3,6; p<0,001 OR: 3,2; p=0,03 HR: 1,7, respectivamente).

Conclusiones

El síndrome metabólico se asocia a peores hallazgos en la pieza de prostatectomía radical y es un factor pronóstico independiente de recidiva bioquímica.

Palabras clave:
Cáncer de próstata
Síndrome metabólico
Grado de Gleason
Recidiva bioquímica

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