Are Diabetic Patients at Increased Risk for Biochemical Recurrence After Radical Prostatectomy?

Abstract

IntroductionDiabetic patients are at a lower risk for prostate cancer. However, the relationship between diabetes mellitus (DM) and biochemical recurrence (BCR) after radical prostatectomy (RP) is less clear. The goal of our study was to determine diabetes's value as a biochemical recurrence predictor. Materials and methodsWe conducted a retrospective analysis of 117 patients who had undergone open radical prostatectomy between 1999 and 2021 at our institution. Univariate and multivariate statistical analyses were used to identify factors associated with biochemical recurrence. ResultsOn univariate analysis, factors associated with biochemical recurrence were diabetes (p=0.002), preoperative prostate-specific antigen (PSA) levels (p=0.022), positive digital rectal exam (p=0.035), number of positive biopsy cores (p<0.001), unfavorable intermediate risk group (p=0.014), peri-neural invasion (PNI) on RP specimen (p=0.043), tumor volume (p=0.011), and positive surgical margins (p<0.001). Multivariate analysis showed that factors independently associated with biochemical recurrence were diabetes (p=0.039; OR=2.788), number of positive cores (p=0.016; OR=4.124), and positive surgical margins (p=0.008; OR=3.876). ConclusionA history of diabetes mellitus should be taken into consideration when assessing patients' risk of biochemical recurrence after radical prostatectomy. More research on a larger scale is needed to determine diabetes' value as a biochemical predictor.

Prediagnostic markers of insulin resistance and prostate cancer risk and death: A pooled study

“…Consistent with other studies, 12 , 13 , 14 , 15 , 16 , 17 higher glucose and TyG index levels were related to a higher risk of PCa death in our study. Patient studies have provided some evidence that men with PCa and T2DM are at an increased risk for biochemical recurrence after radical prostatectomy, 46 , 47 further supporting a role of insulin resistance in PCa progression. In our study, we found that higher glucose levels and the TyG index related to a higher risk of PCa death only in the case‐only analysis, and not in the full cohort.…”