Metabolic syndrome and its components predict the biochemical recurrence and adverse pathological features of patients following radical prostatectomy: a propensity score matching study

Abstract

Background To investigate the predictive value of metabolic syndrome (MetS) and its components in biochemical recurrence (BCR) and adverse pathological features of patients with prostate cancer (PCa) after radical prostatectomy (RP). Methods A total of 525 PCa patients who underwent RP between 2010 and 2019 at Peking University Third Hospital were analyzed retrospectively. The Kaplan–Meier method was performed to assess BCR-free survival (BCRFS). Univariate and multivariate Cox regression models and multivariate logistic regression models were conducted to identify the predictive factors of BCRFS and adverse pathological features respectively before and after propensity score matching (PSM). Results Enrolled patients were allocated into MetS group (n = 136) and non-MetS group (n = 389) according to the presence or absence of MetS, and 127 new matched pairs were identified to balance the baseline characteristics after 1:1 PSM. In propensity matched patients, the Kaplan–Meier analysis revealed that MetS (P = 0.020), hyperglycemia (P = 0.015) and hypertriglyceridemia (P = 0.001) were significantly associated with worse BCRFS; the results of multivariate Cox analyses showed that hyperglycemia (P = 0.040), hypertriglyceridemia (P = 0.017), percentage of positive biopsy cores (P = 0.041) and prostate specific antigen (P = 0.019) were identified as independent prognostic factors for BCRFS. In addition, hypertriglyceridemia was independently associated with non-organ confined disease (NOCD) (P = 0.010), extra-capsular extension (ECE) (P = 0.010) and upgrading (P = 0.017) in the multivariate logistic analyses. Conclusions Hyperglycemia and hypertriglyceridemia are the two effective MetS components both identified as independent risk factors for worse BCRFS after RP, while hypertriglyceridemia was independently associated with NOCD, ECE and upgrading as well.

Differences in the expression of the phosphatase PTP-1B in patients with localized prostate cancer with and without adverse pathological features

“…Our sample was relatively small, and to detect an improvement over already available pre-prostatectomy prognostic factors, our experiment might need to be replicated in a larger cohort. Hyperglycemia and other components of the metabolic syndrome have been associated with an increased prevalence of adverse pathological features and an increased risk biochemical recurrence of prostate cancer (31). Interestingly, in our study, PTP-1B expression was significantly associated with adverse pathological features, while the presence of diabetes mellitus and metformin usage were not.…”

Metabolic syndrome is associated with PSA biochemical recurrence after radical prostatectomy: a prospective study with a minimum 5-year follow-up

“…More recently, Liu et al employed a propensity score matching approach in a retrospective series of radical prostatectomy cases, studying 127 patients with metabolic syndrome and an equal number of matched patients without metabolic syndrome. Their ndings revealed an association between metabolic syndrome and PSA biochemical recurrence (p = 0.018) (23) Notably, all these studies were retrospective in nature, whereas our investigation involved a prospective study of our cohort.…”